Cytologic features of metastatic lymphoepithelial carcinoma in pleural fluid: a case report.

Abstract

BACKGROUND: Lymphoepithelial carcinoma of the salivary gland is a rare undifferentiated or poorly differentiated squamous cell carcinoma associated with abundant inmphocytes. Only a handful of reports descibe the cytologic features of fine needle aspiration in lymphoepithelial carcinoma of the salivary gland and lymph nodes. CASE: A 29-year-old man presented with a painless mass in his right parotid gland. After the surgical specimen was evaluated, the mass was diagnosed as a lymphoepithelial carcinoma, which extended to the periglandular soft tissue with lymph node metastasis. Despite radiation and chemotherapy, multiple mediastinal lymph node metastases, including in the right hilar lymph nodes, occurred. Pulmonary atelectasis of the right upper lobe and a right pleural effusion developed. Aspiration cytology of metastatic lymph nodes and pleural effusion cytology both demonstrated strongly cohesive clusters of tumor cells. These cells had vesicular nuclei and prominent nucleoli admixed with benign lymphoid cells. CONCLUSION: Pleural effusion cytopathology ofmetastatic lymphoepithelial carcinoma is similar to that of primary tumor fine needle aspiration. Therefore, a specific diagnosis of lymphoepithelial carcinoma is possible on the basis of body fluid with these cytologic features.