| Objective: To improve the understanding of the clinical characteristics, diagnosis, and treatment of pulmonary lymphoepitheliomatous carcinoma. Method: On October 22, 2022, a case of postoperative recurrence of primary pulmonary lymphoepitheliomatous carcinoma admitted to Tiantai County People""s Hospital was reported, and relevant literature at home and abroad was reviewed. Result: Patient, female, 70 years old. History of smokeless drinking habits. Due to coughing, a chest CT scan showed a soft tissue mass shadow in the medial segment of the middle lobe of the right lung, corresponding to bronchial occlusion. Tracheoscopy indicates a new growth in the right middle lobe opening. Performing radical surgery for right middle lung cancer (right middle lung sleeve resection+mediastinal lymph node dissection+partial pericardial resection), postoperative pathology: central type lymphoepitheliomatous carcinoma of the right lung, immunohistochemistry: small RNA encoded by EB virus (EBER) (4+). More than 2 years after surgery, recurrence accompanied by pleural and lymph node metastasis occurred. After 2 cycles of chemotherapy and immunization, the tumor almost completely retreated, and long-term survival benefits are currently being gained. This disease often presents with cough and chest pain symptoms. When the mass is large, CT can easily show invasion of bronchi, blood vessels, and lymph node metastasis. The pathological features include a large number of lymphatic plasma cells distributed in the interstitium and positive EBER detection in the tissue. Early postoperative prognosis is better compared to other subtypes of lung cancer, and postoperative recurrence is rare. Late stage treatment with immune checkpoint inhibitors (ICIs) may bring survival benefits. Conclusion: Pulmonary lymphoepitheliomatous carcinoma is a rare lung malignancy associated with EBV, with no distinctive clinical and imaging features, and a better prognosis than other NSCLC subtypes. ICIs treatment for advanced patients may bring long-term survival benefits. |
