Primary tonsil lymphoepithelioma-like carcinoma:a clinicopathological analysis

FAN Rui-rui; GAO Jie

doi:10.3969/j.issn.1007-8096.2025.04.005

Abstract：Objective To investigate the clinicopathological features of primary tonsil lymphoepithelioma-like carcinoma.Methods Clinicopathological data of primary tonsil lymphoepithelioma-like carcinoma were collected and analyzed by HE staining,immunohistochemistry,and molecular detection.Results Under the microscope,the tumor cells were scattered or arranged in nests and sheets,with large size and obvious atypia.The cancer cells were polygonal and round,the cell boundaries were unclear and zygotic,and multinucleated giant cells were visible without the differentiation characteristics of squamous cells.The nuclei were large and mostly vacuolar,and 1 or more eosinophilic nucleoli were visible.There were a large number of small lymphocyte infiltrates between the cancer nests and cancer cells,and local plasma cells and histiocytes were seen.In immunophenotype,the tumor cells expressed CK,CK5/6,P40,P63,but did not express S100,LCA,Vimentin,CgA,CD56,and Syn.Interstitial lymphocytes expressed CD8 and CD20.In situ hybridization showed nuclear positive of EBER,and PCR did not show HPV infection.Conclusion Primary tonsil lymphoepithelioma-like carcinoma is very rare clinically and is easily misdiagnosed before surgery.It should be distinguished from tonsil squamous cell carcinoma,diffuse large B-cell lymphoma,metastatic nasopharyngeal carcinoma,etc.Pathological morphology combined with immunohistochemistry and molecular detection are helpful for accurate diagnosis.