Epstein-Barr Virus-Associated Lymphoepithelial Carcinoma Arising in a Salivary Sebaceous Lymphadenoma

Head Neck Pathol. 2023 Sep;17(3):871-876. doi: 10.1007/s12105-023-01546-w. Epub 2023 Apr 6.

Abstract

Background: Lymphadenomas are rare benign tumors of the major salivary glands that are further classified as sebaceous and non-sebaceous. No association with viruses has been reported so far. Little is known about the mechanisms that allow lymphadenomas to undergo malignant transformation. Among these rare instances, there has never been a malignant transformation to Epstein-Barr virus (EBV)-associated lymphoepithelial carcinoma.

Methods: Clinical data of the reported case were retrieved from the patient's electronic medical record. Hematoxylin & eosin-stained slides, immunohistochemical tests, and in situ hybridization performed for routine diagnostic purposes were reviewed.

Results: We report a salivary gland sebaceous lymphadenoma in which the luminal components were mostly replaced by malignant epithelial cells with markedly atypical nuclear features. Presence of EBV was demonstrated in all components by EBER. The morphological and immunohistochemical findings were consistent with a lymphoepithelial carcinoma arising from a sebaceous lymphadenoma.

Conclusion: We report the first case of an Epstein-Barr virus-associated lymphoepithelial carcinoma arising from a sebaceous lymphadenoma.

Keywords: Epstein–Barr virus; Lymphadenoma; Lymphoepithelial carcinoma; Parotid tumor; Salivary gland tumor.

Publication types

  • Case Reports

MeSH terms

  • Carcinoma, Squamous Cell* / pathology
  • Epstein-Barr Virus Infections* / complications
  • Herpesvirus 4, Human / genetics
  • Humans
  • In Situ Hybridization
  • Parotid Neoplasms* / pathology
  • Salivary Gland Neoplasms* / pathology