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Vol. 57. Issue 10.
Pages 651 (October 2021)
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Vol. 57. Issue 10.
Pages 651 (October 2021)
Clinical Image
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88-Year-Old Woman With an Incidental Lung Mass
Mujer de 88 años con una masa pulmonar incidental
Oriana Salamoa,
Corresponding author
, Sujith V. Cherianb, Rosa M. Estrada-Y-Martinb
a University of Texas Health Science Center at Houston, Department of Internal Medicine, Houston, TX, USA
b University of Texas Health Science Center at Houston, Department of Pulmonary, Critical Care and Sleep Medicine, Houston, TX, USA
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A 88-year-old woman was referred to the pulmonary clinic for evaluation of a asymptomatic left lung mass which was incidentally found on chest radiographs. CT scan of the thorax showed a 6.4cm mass, and additional PET scan failed to reveal metastatic disease. An endobronchial ultrasound guided-biopsy was performed, and pathology showed neoplastic cells with large nuclei arranged in nests, with positive staining for pancytokeratin AE1/AE3, CK5/6, P40 and EBER-in situ hybridization, ultimately favoring the diagnosis of Epstein–Barr virus positive lymphoepithelioma-like carcinoma (PLELC) instead of squamous cell carcinoma of the lung (Fig. 1). Further tests revealed a low pulmonary reserve, and given her age, lack of symptoms and the size of the primary lesion, a decision for “watchful waiting” with frequent surveillance imaging was made.

Fig. 1.

(A, B) 6.4cm heterogenous mass replacing the lingula with large endobronchial component. (C) Hematoxylin and eosin-stained section of lung (400×). (D) Tumor cells with positive CK5/6 staining (100×). (E) Neoplastic cells with positive staining for pancytokeratin AE1/AE3 (100×). (F) Neoplastic cells P40 positive (100×).


PLELC is a rare type of non-small cell lung cancer associated with Epstein–Barr; has been mostly described in young non-smoker Asians accounting for only 0.9% of primary lung malignancies.1 Noticeably, 35% of the patients are asymptomatic when the tumor is incidentally found. Unfortunately, there is no standard treatment for PLELC at this time due to its rarity, but overall, patients have a significantly better prognosis when compared to other lung malignancies.2

Conflict of Interests

The authors declare no actual or potential conflict of interests.

B. Chen, X. Chen, P. Zhou, L. Yang, J. Ren, X. Yang, et al.
Primary pulmonary lymphoepithelioma-like carcinoma: a rare type of lung cancer with a favorable outcome in comparison to squamous carcinoma.
Respir Res, 20 (2019), pp. 262
Y. Qin, G. Gao, X. Xie, Z. Zhu, W. Guan, X. Lin, et al.
Clinical features and prognosis of pulmonary lymphoepithelioma-like carcinoma: summary of eighty-five cases.
Clin Lung Cancer, 20 (2019), pp. e329-e337
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