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Clinical Problem Solving: Pathology
March 2003

Pathology Quiz Case 2—Diagnosis

Author Affiliations
 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2003;129(3):372. doi:10.1001/archotol.129.3.370

Lymphoepithelial carcinoma was first described in 1921 as a variant of SCC.1 Lymphoepithelial carcinoma grows either in nests or as single infiltrating cells with round or oval vesicular nuclei, prominent nucleoli, indistinct cellular borders, and numerous mitoses. The cells are undifferentiated and nonkeratinizing and stain positive for epithelial markers such as cytokeratin and epithelial membrane antigen. A prominent lymphoid infiltrate composed of lymphocytes and plasma cells differentiates LEC from conventional SCC. The epithelial cells are the neoplastic component of the tumor, while the lymphocytic infiltrate is considered to be reactive in nature. Generally, there is little desmoplastic or fibrous connective stroma,15 and there is no characteristic gross appearance. The reported tumors have ranged in size from 0.8 to 4.5 cm in greatest dimension.6

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