DataSheet_4_Case Report: Primary lymphoepithelioma-like intrahepatic cholangiocarcinoma.zip

BackgroundLymphoepithelioma-like intrahepatic cholangiocarcinoma (LEL-ICC) is a rare variant of intrahepatic cholangiocarcinoma. Epstein–Barr virus (EBV) infection was considered to play a pivotal role in the tumorigenesis of LEL-ICC. It is difficult to diagnosis of LEL-ICC due to the lack of specific features regarding the laboratory test results and imaging findings. At present, the diagnosis of LEL-ICC mainly depends on the histopathologic and immunohistochemical examinations. In addition, the prognosis of LEL-ICC was better than classical cholangiocarcinomas. To our knowledge, only few cases of LEL-ICC have been reported in the literature.
Case presentationWe presented a case of a 32-year-old Chinese female with LEL-ICC. She had a 6-month history of upper abdominal pain. The magnetic resonance imaging (MRI) showed a 1.1× 1.3 cm lesion in the left lobe of liver, appearing low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. The patient underwent laparoscopic left lateral sectionectomy. The postoperative histopathologic and immunohistochemical examinations results allowed for the definitive diagnosis of LEL-ICC. The patient was free from tumor recurrence after a 28 months follow-up.
ConclusionIn this study, we reported a rare case of LEL-ICC associated with both HBV and EBV infection. EBV infection might play a pivotal role in the carcinogenesis of LEL-ICC, and surgical resection is still the most effective treatment at present. Further research on the etiology and treatment strategies of LEL-ICC is required.

背景
淋巴上皮瘤样肝内胆管癌（Lymphoepithelioma-like intrahepatic cholangiocarcinoma, LEL-ICC）是肝内胆管癌的罕见亚型。既往认为Epstein-Barr病毒（Epstein–Barr virus, EBV）感染在LEL-ICC的肿瘤发生过程中发挥关键作用。由于该疾病缺乏特异性实验室检查结果与影像学表现，其临床诊断难度较大。目前，LEL-ICC的确诊主要依赖组织病理学及免疫组织化学检测。此外，LEL-ICC的预后优于经典型胆管癌。据我们所知，目前公开文献中仅报道了少量LEL-ICC病例。

病例报告
我们报道1例32岁中国女性LEL-ICC患者。该患者有6个月的上腹痛病史。磁共振成像（Magnetic Resonance Imaging, MRI）检查显示其肝左叶存在1.1×1.3 cm的病灶，T1加权像呈低信号，T2加权像呈高信号。患者接受了腹腔镜左肝外侧叶切除术。术后组织病理学及免疫组织化学检测结果明确确诊为LEL-ICC。经过28个月的随访，患者未出现肿瘤复发。

结论
本研究报道1例同时合并乙型肝炎病毒（Hepatitis B virus, HBV）与EBV感染的罕见LEL-ICC病例。EBV感染可能在LEL-ICC的癌变进程中发挥关键作用，目前手术切除仍是最有效的治疗手段。未来仍需开展更多针对LEL-ICC病因及治疗策略的相关研究。