Lymphoepithelioma-like gastric carcinoma: an unusual consequence of Epstein-Barr virus infection in an HIV-infected woman

Int J STD AIDS. 2013 Jan;24(1):59-62. doi: 10.1258/ijsa.2012.012131. Epub 2013 May 6.

Abstract

Lymphoepithelioma-like-gastric carcinoma (LEL-GC) is an Epstein-Barr virus (EBV)-associated neoplasm of the stomach reported to have a better prognosis than conventional gastric adenocarcinoma. Unlike other EBV-associated malignancies, particularly lymphoproliferative disorders and undifferentiated nasopharyngeal carcinoma, for which risk has been shown to increase in human immunodeficiency virus (HIV) infection, LEL-GC remains rare; only one HIV-infected patient with LEL-GC has been reported previously. We describe an aggressive case of EBV-associated LEL-GC in a woman co-infected with HIV 1 and hepatitis C virus. In situ hybridization of an endoscopic biopsy specimen for EBV-encoded small RNA confirmed the presence of this agent exclusively in the gastric cancer cells. Our patient had recently started antiretroviral therapy, suggesting that immune reconstitution may have been a factor in presentation of this tumour.

Keywords: AIDS; EBV; Epstein–Barr virus; HIV; lymphoepithelioma-like gastric carcinoma; malignancy.

Publication types

  • Case Reports

MeSH terms

  • AIDS-Related Complex / drug therapy
  • AIDS-Related Complex / pathology
  • Adenocarcinoma / pathology
  • Adenocarcinoma / virology
  • Aged
  • Anti-HIV Agents / therapeutic use
  • Antineoplastic Agents / therapeutic use
  • Biopsy
  • Epstein-Barr Virus Infections / complications*
  • Epstein-Barr Virus Infections / drug therapy
  • Epstein-Barr Virus Infections / pathology
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV-1
  • Hepacivirus
  • Hepatitis C / complications*
  • Herpesvirus 4, Human / isolation & purification*
  • Humans
  • Immune Reconstitution Inflammatory Syndrome / complications
  • Lymphoproliferative Disorders / drug therapy
  • Lymphoproliferative Disorders / pathology
  • Neoplasm Staging
  • RNA, Viral / analysis
  • Stomach Neoplasms / complications*
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / virology*
  • Treatment Outcome

Substances

  • Anti-HIV Agents
  • Antineoplastic Agents
  • RNA, Viral