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Lymphoepithelioma-like Carcinoma of the Lung: Radiologic Features of an Uncommon Primary Pulmonary Neoplasm

¹ Department of Radiology, University of California, San Francisco, 505 Parnassus Avenue, Room M-391, Box 0628, San Francisco, CA 94110.
² Department of Pathology, San Francisco General Hospital, San Francisco, CA 94110.
³ Department of Radiology, Mayo Clinic, Rochester, MN 55905.
⁴ Scottsdale Medical Imaging, Ltd., an Affiliate of Southwest Diagnostic Imaging, Scottsdale, AZ 85252.

OBJECTIVE. The purpose of this study was to review the chest radiographic, CT, and MRI appearances of primary pulmonary lymphoepithelioma-like carcinoma (LELC).

CONCLUSION. Primary pulmonary LELC is histopathologically identical to nasopharyngeal carcinoma. The radiographic, CT, and MRI features of primary pulmonary LELC are nonspecific, often resembling those of bronchogenic carcinoma. Primary pulmonary LELC usually presents as a poorly circumscribed, enhancing, peripheral solitary pulmonary nodule on CT; necrosis may be present and is considered a poor prognostic sign. MRI shows isointense to low-intensity signal on T1-weighted images and mildly increased signal on T2-weighted images; enhancement of abnormal tissue is typical. Most patients present with early-stage disease. Primary pulmonary LELC should be suspected in selected patients and requires differentiation from bronchogenic carcinoma and metastatic nasopharyngeal carcinoma.

Keywords: biopsy • CT • Epstein-Barr virus • lung cancer • MRI • primary pulmonary lymphoepithelioma-like carcinoma

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