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Primary lymphoepithelial carcinoma of the hypopharynx: an extremely rare non-nasopharyngeal presentation

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Rana A. K., Sharma R., Sharma V., Agrawal T., Mehrotra A.
Polski Przegląd Otorynolaryngologiczny
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2020
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vol. 9(4)
67-72
EN
Introduction: A 66-year-old male complained of throat discomfort and odynophagia. Laryngeal fiber optic examination was normal but narrow band imaging was suspicious. USG-FNAC from a cervical lymph node was positive for malignant metastatic carcinoma cells. CECT revealed obliteration of the left pyriform fossa till the level of cricoid cartilage, abutting the ala of the thyroid cartilage, arytenoid cartilage and prevertebral muscles. UGIE revealed an ulcerated mass lesion in the left pyriform fossa. Histopathological examination revealed stratified non-keratinized squamous epithelial lined tissue with subepithelial stroma showing large round to polygonal tumour cells. The tumour cells were surrounded by a lymphoid stroma. On immunohistochemistry the tumour cells were positive for pancytokeratin and negative for CD45, chromogranin and synaptophysin. Lymphocytes were positive for CD45. The diagnosis of lymphoepithelial carcinoma was established. The tumour was inoperable and was treated by radiotherapy. Conclusions: Lymphoepithelial carcinoma is the primary entity of the nasopharynx but rarely seen at sites like oropharynx, larynx and hypopharynx. Only around 50 non-nasopharyngeal cases have been reported till date out of which only 10–12 were in the hypopharynx. Radiotherapy is the mainstay of treatment whereas surgery can be considered for a local disease.
2
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Detection of specific lytic and latent transcripts can help to predict the status of Epstein-Barr virus infection in transplant recipients with high virus load

100%
Zawilinska B., Kosinska A., Lenart M., Kopec J., Piatkowska-Jakubas B., Skotnicki A., Kosz-Vnenchak M.
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2008
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vol. 55
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issue 4
693-699
EN
Epstein-Barr virus (EBV), a member of the family Herpesviridae, is widely spread in the human population and has the ability to establish lifelong latent infection. In immunocompetent individuals the virus reactivation is usually harmless and unnoticeable. In immunocompromised patients productive infection or type III latency may lead to EBV-associated post-transplant lymphoproliferative disorder (PTLD). The aim of our research was to investigate the utility of PCR-based methods in the diagnosis and monitoring of EBV infections in bone marrow transplant recipients. Thirty-eight peripheral blood leukocyte samples obtained from 16 patients were analysed, in which EBV DNA was confirmed by PCR. We used semi-quantitative PCR to estimate the viral load and reverse-transcription PCR (RT-PCR) to differentiate between latent and productive EBV infection. In 14 patients we confirmed productive viral infection. We observed a correlation between higher number of EBV genome copies and the presence of transcripts specific for type III latency as well as clinical symptoms.
3
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Przebieg i diagnostyka zakażenia EBV u dzieci – obserwacje kliniczne

72%
Kalicki B., Maślany A., Milart J., Jung A.
Pediatria i Medycyna Rodzinna
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2011
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vol. 7
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issue 3
247-252
EN
Epstein-Barr virus (EBV) infections in children are usually asymptomatic and occur in almost the entire population. If the infection occurred at a later age, in adolescents and adults, it can lead to infectious mononucleosis (IM). A typical symptom is long-lasting fever, which is of concern, especially in younger patients and those who do not respond to antibiotic therapy. The paper presents the characteristics, epidemiology, and pathophysiology of EBV infection. It is described both common and rare features of the most common form of symptomatic infections – infectious mononucleosis. IM is suspected primarily in children with fever, sore throat and enlarged lymph nodes, liver and spleen. EBV infection can cause mucocutaneous manifestation, weakness and myalgia; hepatitis is relatively less common and can lead to liver failure. Laboratory diagnosis is primarily an assessment of morphology and peripheral blood smear, with the presence of the predominant atypical lymphocytes. Evaluation of serum transaminases level (elevated in infectious mononucleosis), and serological tests for the presence of antiviral antibodies are also crucial. If the heterophil test is negative in the patients with symptoms suggesting IM, one should carry out EBV-specific antibody tests. Antibodies to viral capsid antigen (VCA) appear as the first. The paper reports three cases of infectious mononucleosis and diagnostic problems associated with them.
PL
Zakażenia wirusem Epsteina-Barr (Epstein-Barr virus, EBV) u dzieci najczęściej przebiegają bezobjawowo i dotyczą niemalże całej populacji. U części osób, szczególnie jeśli do zakażenia doszło w wieku późniejszym (u nastolatków i dorosłych), mogą prowadzić do wystąpienia mononukleozy zakaźnej (MZ). Typowym objawem jest długo utrzymująca się gorączka, co budzi niepokój, zwłaszcza u pacjentów najmłodszych i tych, którzy nie reagują na zastosowaną antybiotykoterapię. W pracy przedstawiono charakterystykę, epidemiologię, oraz patofizjologię zakażenia EBV. Opisano zarówno typowe, jak i rzadkie cechy najczęstszej objawowej postaci zakażenia – mononukleozy zakaźnej. MZ podejrzewamy przede wszystkim u dzieci z gorączką, zapaleniem gardła oraz powiększeniem węzłów chłonnych, wątroby i śledziony. Zakażenie EBV niekiedy powoduje również zmiany skórne, osłabienie, bóle mięśniowe, rzadko występuje zapalenie wątroby, które może prowadzić do jej niewydolności. Diagnostyka laboratoryjna obejmuje przede wszystkim ocenę morfologii z rozmazem krwi obwodowej, w którym przeważają limfocyty atypowe, aktywność aminotransferaz (podwyższonych w MZ) oraz testach serologicznych na obecność przeciwciał przeciwwirusowych. W przypadku otrzymania ujemnych wyników testów lateksowych i objawów klinicznych sugerujących MZ należy wykonać testy wykrywające swoiste antygeny wirusa. Przeciwciała pojawiające się jako pierwsze to te skierowane przeciwko antygenowi kapsydowemu wirusa. W pracy przedstawiono także opisy trzech przypadków mononukleozy zakaźnej i problemów diagnostycznych z nimi związanymi.
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