Metastatic lymphoepithelioma-like carcinoma of the lung treated with nivolumab: a case report and focused review of literature

Abstract

In recent years, significant advances have been made in cancer immunotherapy. Here, we present the first report of a patient with lymphoepithelioma-like carcinoma (LELC) of the lung, an Epstein-Barr virus (EBV)-associated lung cancer, who was treated with nivolumab, a fully human IgG4 anti-PD-1 monoclonal antibody. We also carry out a focused review to identify and examine studies of LELC of the lung in the literature. This case report highlights the need to further assess the role of immune checkpoint inhibitors in LELC of the lung.

Keywords: Lymphoepithelioma-like carcinoma of the lung (LELC of the lung); immunotherapy; nivolumab.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1

Microscopic findings of the resected tumor. Undifferentiated carcinoma with poorly defined nests of neoplastic cells within a stroma exhibiting prominent lymphoplasmacytic infiltrate (A, hematoxylin and eosin, 20×). EBV-encoded RNA (EBER) in situ hybridization shows intense signal in most of the neoplastic cells (B, 20×). Moderate to strong PD-L1 expression by the majority of neoplastic cells (C, 20×). Intratumoral CD8+ positive lymphoid cells are also present (D, 20×).

Figure 2

Computed tomography (CT) findings. (A) A restaging CT scan obtained after 6 cycles of systemic chemotherapy shows new and enlarging pulmonary metastases (arrowheads) and hepatic metastases (arrows); (B) a restaging scan obtained after one dose of nivolumab shows increased pulmonary (arrowheads) and hepatic metastatic lesions (arrows).