2001 Volume 47 Issue 4 Pages 251-254
This paper describes a case of lymphoepithelioma. The patient was 78-year-old man, and his chief complaint was swelling of the right submandibular region. The lesion was extirpated for a clinical diagnosis of chronic lymphoadenitis. The swelling was lymph node metastasis from lymphoepithelioma. The origin of the tumor could not be determined by CT, MRI, 67Ga scintigraphy, or optical endoscopy of the head and neck region. The extirpated lymph node measured 35×22×24mm, and the cut surface of the tumor was solid and yellowishwhite. Histopathologic examination revealed epithelial tumor cells with light or eosinophilic cytoplasm. Large nucleoli were observed clearly in almost all epithelial tumor cells. Many tumor cells showed mitosis, indicating severe atypism. Numerous lymphocytes infiltrated the stroma. On serological examination, anti-VCA-IgG, anti-VCA-IgA, and anti-EBNA antibodies were 320, 80, and 160 fold (cut off value: below 10), respectively. The EBV-gene was detected in the nuclei of tumor cells by in situ hybridization. A new tumor developed between the temporal muscle and lateral pterygoid muscle on the right side 2.5 years after presentation. The histopathological features were identical to those of the previous tumor. The patient died of lung metastasis 4.8 years after presentation.
