• bladder cancer variants
• diagnostic pitfalls
• the Paris system for urinary cytology
• urine cytology
• urothelial carcinoma

• Humans
• Urinary Bladder Neoplasms/diagnosis
• Urinary Bladder Neoplasms/genetics
• Urinary Bladder Neoplasms/pathology
• Carcinoma, Transitional Cell/diagnosis
• Carcinoma, Transitional Cell/genetics
• Carcinoma, Transitional Cell/pathology
• Retrospective Studies
• Urinary Tract/pathology
• Cytodiagnosis
• Urothelium/pathology
• Urologic Neoplasms/diagnosis
• Urologic Neoplasms/genetics
• Urologic Neoplasms/pathology
• Urine

• Humans
• Carcinoma, Transitional Cell/pathology
• Urinary Bladder Neoplasms/therapy
• Urinary Bladder Neoplasms/pathology
• Urinary Bladder/pathology
• Carcinoma, Squamous Cell/pathology
• Carcinoma in Situ/pathology
• Neoplasm Grading

• bladder mass
• laparoscopic partial cystectomy
• lymphoepithelioma-like carcinoma
• surgical case reports
• urinary bladder carcinoma

• Epstein-Barr virus
• celiac disease
• lymphoepithelioma-like carcinoma

The genetic features of primary lymphoepithelioma‐like carcinoma (LELC) of the upper urinary tract have not been systematically explored. In this study, tumor mutation profiling was performed using whole‐genome sequencing in two patients with LELC of the renal pelvis. Novel candidate variants relevant to known disease genes were selected using rare‐variant burden analysis. Subsequently, a population‐based study was performed using the Surveillance, Epidemiology, and End Results (SEER), PubMed, MEDLINE, Embase, and Scopus databases to explore clinical features and prognostic risk factors. Immunohistochemical analysis revealed seven positive cytokeratin‐associated markers in tumor cells and five positive lymphocyte‐associated markers in and around the tumor area. Sub‐sequently, we identified KDM6A as the susceptibility gene and LEPR as the driver gene by Sanger sequencing in case 2 of LELC of the renal pelvis. Three mutation sites of the existing targeted drugs were screened: CA9, a therapeutic target for zonisamide; ARVCF, a therapeutic target for bupropion; and PLOD3, a therapeutic target for vitamin C. In a population‐based study, patients with primary LELC of the upper urinary tract had clinical outcomes similar to those of patients with primary upper urinary tract urothelial carcinoma (UUT‐UC) before and after propensity score matching at 1 : 5. Focal subtype was an independent prognostic factor for the overall survival of patients with LELC of the upper urinary tract. The carcinogenesis of primary LELC may be due to different genetic variations, including single‐nucleotide variants, insertion and deletions, structural variations, and repeat regions, which may provide the basis for clinical diagnosis and treatment. The prognosis of LELC in the upper urinary tract is similar to that of UUT‐UC. We suggest that the focal subtype can serve as a prognostic factor for LELC of the upper urinary tract; however, further studies are required to confirm this.

Lymphoepithelioma-like carcinoma of the urinary bladder is a rare variant of infiltrating urothelial carcinoma. Diagnostic and therapeutic manipulations are not yet standardised, due to the rarity of the tumour, with surgery and chemotherapy being reported as potential therapeutic options. We report on a case of lymphoepithelioma-like carcinoma of the bladder in a 93-year-old female patient and discuss the pathological features and therapeutic options of the neoplasm. Due to her increased age and associated comorbidities such as hypertension, diabetes mellitus and ischemic heart disease, the patient was treated with transurethral resection of the tumour and subsequent cisplatin-based chemotherapy but unfortunately died of chemotherapy-related complications.

Bladder lymphoepithelioma-like carcinoma is a rare entity. It represents a particular variant of urothelial carcinoma characterized by an important infiltrating power. Therapeutic management of this cancer is not codified. Surgery associated with chemotherapy seems to be the best therapeutic option. Few cases of this tumor have been reported in the literature. We report a case of bladder lymphoepithelioma-like carcinoma in a 52-year-old patient who presented with gross hematuria and discusses difficulties of diagnostic and treatment.

• SEER
• lymphoepithelioma-like
• prognosis
• radical cystectomy
• urinary bladder neoplasm

• Adenocarcinoma
• Epstein-Barr virus
• Gallbladder neoplasm
• Lymphoepithelioma-like carcinoma

The spectrum of architectural and cytological findings in UC is wide, although transitional cell carcinoma, either papillary or flat, low- or high-grade, constitutes the majority of cases in routine practice. Some of these changes are just mere morphological variations, but others must be recognized since they have importance for the patient. The goal of this review is to compile this histological variability giving to the general pathologist a general idea of this morphological spectrum in a few pages. The review also updates the literature focusing specifically on the morphological and immunohistochemical clues useful for the diagnosis and some selected molecular studies with prognostic and/or diagnostic implications.

The overwhelming majority of bladder cancers are transitional cell carcinomas. Albeit mostly monotonous, carcinomas in the bladder may occasionally display a broad spectrum of histological features that should be recognized by pathologists because some of them represent a diagnostic problem and/or lead prognostic implications. Sometimes these features are focal in the context of conventional transitional cell carcinomas, but some others are generalized across the tumor making its recognition a challenge. For practical purposes, the review distributes the morphologic spectrum of changes in architecture and cytology. Thus, nested and large nested, micropapillary, myxoid stroma, small tubules and adenoma nephrogenic-like, microcystic, verrucous, and diffuse lymphoepithelioma-like, on one hand, and plasmacytoid, signet ring, basaloid-squamous, yolk-sac, trophoblastic, rhabdoid, lipid/lipoblastic, giant, clear, eosinophilic (oncocytoid), and sarcomatoid, on the other, are revisited. Key histological and immunohistochemical features useful in the differential diagnosis are mentioned. In selected cases, molecular data associated with the diagnosis, prognosis, and/or treatment are also included.

• bladder cancer
• diagnosis
• differential diagnosis
• histopathology
• immunohistochemistry
• prognosis

• Bladder cancer
• therapy
• urinary bladder neoplasms

• Urothelial carcinoma
• chemosensitivity
• immune checkpoint inhibitor
• immunophenotype
• molecular subtype
• prognosis
• variant histology

Urinary tract lymphoepithelioma-like carcinoma is rarely seen. Although it is termed after lymphoepithelioma at the nasopharynx, it behaves more like high grade urothelial carcinoma by immunohistochemical features. Most published literatures focused on its rarity but few discussed results of long-term follow-ups. As no available guidelines are applicable, we postulated that principles should be similar to that of urothelial carcinoma at urinary tract. As of now, this work features the longest follow-up of this cancer at the upper urinary tract.

A 63-year-old female had a chief complaint of intermittent left flank pain for 2 mo, along with accompanying symptoms including vomiting and body weight loss, about 7 kg over 2 mo. Laboratory data showed normocytic anemia, mildly poor renal function, and hyperparathyroidism. Urine analysis showed mild hematuria. Computed tomography showed a 4.2-cm-width irregular mass over left renal pelvic and enlarged lymph node at the left renal hilum. Whole-body bone scan was negative of active bone lesions. Biopsy from ureteroscopy showed urothelial carcinoma. Specimen from laparoscopic nephroureterectomy with bladder cuff resection showed lymphoepithelioma-like carcinoma with muscular invasion (pT3). She took adjuvant chemotherapies of 2 cycles and full courses of radiation therapy. No recurrence was observed with designed investigative programs.

Locally advanced urinary tract lymphoepithelioma-like carcinoma could benefit from nephroureterectomy and bladder cuff excision in terms of recurrence-free survival.

• Urologic neoplasms pathology
• Kidney pelvis
• Tomography X-ray computed
• Carcinoma mortality
• Kidney neoplasms mortality
• Case report

Lymphoepithelioma-like carcinoma (LELC) is a rare, malignant epithelial tumour which can arise within the upper urinary tract. This letter adds to a previous systematic review and cumulative analysis of 28 published upper urinary tract-LELC cases which provided insight into this disease; however, the current evidence does not provide clinicians with clear guidelines due to its rarity. Therefore, the aim was to report a new case of renal pelvis LELC presented in our hospital. In this instance, we were able to report treatment experience and long-term follow-up results. This patient presented with hypertension and haemturia which initiated further investigation. While ultrasound identified an hypechoic mass, no malignant cells were detected using cytological testing. Abdominal magnetic resonance imaging identified a slightly enhanced mass in the left renal pelvis with no evidence of lymph node metastasis. Ureteroscopic tumor biopsy suggested the existence of urothelial carcinoma, hence, laparoscopic radical left nephroureterectomy with bladder cuff excision was performed. Through patient-practitioner consultations, we decided to adopt a "watch and wait" approach after radical nephroureterectomy rather than administering chemotherapy. Although, we would encourage clinicians to record and publish cases to garner insight into this type of malignant disease.

• Lymphoepithelioma-like carcinoma
• Prognosis
• Radical nephroureterectomy
• Upper urinary tract
• Treatment
• Case report

• lung cancer
• cancer genetics

• Adult
• Aged
• B7-H1 Antigen/analysis
• B7-H1 Antigen/antagonists & inhibitors
• Biomarkers, Tumor/analysis
• Biomarkers, Tumor/genetics
• Carcinoma, Non-Small-Cell Lung/drug therapy
• Carcinoma, Non-Small-Cell Lung/genetics
• Carcinoma, Non-Small-Cell Lung/immunology
• China
• Epigenesis, Genetic
• Female
• Gene Amplification
• Gene Dosage
• Genetic Predisposition to Disease
• Humans
• Immune Checkpoint Inhibitors/therapeutic use
• Lung Neoplasms/drug therapy
• Lung Neoplasms/genetics
• Lung Neoplasms/immunology
• Male
• Middle Aged
• Mutation
• Phenotype
• Transcriptome
• Treatment Outcome
• Young Adult

• State Key Laboratory of Respiratory Disease (SKLRD)
• Guangdong High Level University Clinical Cultivation Project [grant number: 2017-21020]; Wu Jieping Medical Foundation Special Funding for Clinical Research [grant number: 320.6750.18125]

Lymphoepithelioma-like carcinomas (LELCs) are rare, malignant epithelial tumors, generally considered a subtype of squamous cell carcinoma. LELCs are undifferentiated and can occur in multiple tissues, although LELCs in the urinary tract are extremely rare. As such, evidence does not provide clinicians with guidelines for the best practices. Even though this is a rare disease, it is associated with high morbidity and mortality. Therefore, we must learn to differentiate LELC types and identify risk factors for early identification.

To develop an evidence base to guide clinicians treating primary LELCs of the upper urinary tract (UUT-LELC).

We performed a systematic review of all reports on UUT-LELC from the first published case in 1998 until October 2019, according to the PRISMA. A database was then developed by extracting data from previously published reports in order to analyze interactions between clinical characteristics, pathological features, interventions and outcomes. Survival was analyzed using Kaplan–Meier estimates, which were compared using log rank tests.

A total of 28 previously published cases were identified for inclusion. The median age was 72 years with a male to female ratio of 4:3. Pure type LELCs were most common with 48.3% (n = 14), followed by 37.9% (n = 11) predominant LELCs and 3.4% (n = 1) focal LELCs. Epstein-Barr virus testing was negative in all cases. Fourteen patients received radical nephroureterectomy (RNU)-based intervention. Twenty-three patients survived with no evidence of further metastasis, although six died before the median 18 mo follow-up point. Survival analysis suggests pure histological subtypes, and patients who receive complete tumor resection have more favorable prognoses. As always in cancer care, early identification generally increases the probability of interventional success.

The most effective treatment for UUT-LELC is RNU-based therapy. Since cases are few in number, case reporting must be enhanced and publishing encouraged to both save and prolong lives.

• Lymphoepithelioma-like carcinoma
• Prognosis
• Radical nephroureterectomy
• Upper urinary tract
• Systematic review
• Case report

• biomarkers
• clinical trials
• immune checkpoint inhibitor
• immunotherapy
• urothelial carcinoma

Lymphoepithelial - like carcinoma, is rarely recognized in the urinary bladder and less commonly occurs with papillary transitional cell carcinoma i.e. mixed pattern. Also, less uncommon is the occurrence of carcinoma in situ changes in the adjacent urothelium of these tumors. Here, a case of lymphoepithelial – like carcinoma and papillary transitional cell carcinoma associated with carcinoma in situ changes of urothelium of the urinary bladder has been reported the prognosis of this type of malignancy as well as its management will be discussed. Meanwhile, immunohistochemical stains have been carried out to differentiate it from lymphoma of the urinary bladder and the findings will be discussed.

• Carcinoma in situ
• Urinary Bladder
• like carcinoma

Lymphoepithelioma-like carcinoma of the bladder (LELCB) is a rare variant of urothelial carcinoma first described by Zukerberg in 1991 and confirmed as a variant of urothelial carcinoma by the WHO classification of tumors of the urinary system. LELCB is characterized by a marked infiltration of lymphocytes in the area involved by the tumor which may coexist with the conventional urothelial carcinoma. LELCB are classified according to the percentage of lymphoepithelioma component within the tumor with the prognosis depending on the percentage. We report a new case of pure LELCB occurring in 63-year-old woman presenting with hematuria. Ultrasonography and cystoscopy revealed a large tumor on the left lateral wall of the bladder. Transurethral resection of the bladder tumor (TURBT) was performed. Pathological and immunohistochemical analysis revealed a high-grade muscle-invasive LELCB (G3pT2). The patient underwent an adjuvant systemic chemotherapy with no recurrence after a ten-month follow-up. To our knowledge, this is the second Moroccan case of LELCB reported in the English literature. Although its rare occurrence prognosis and ideal therapeutic management of LELCB have not been clearly established yet, literature findings encourage the adoption of a conservative approach in treatment of LELCB.

• Bladder cancer
• cystectomy
• outcomes
• urothelial carcinoma
• variant histology

• Bladder
• Cystectomy
• Lymphoepithelioma-like carcinoma

• Lymphoepithelioma
• Lymphoepithelioma-like
• Renal pelvis
• Ureter

• Aged
• Aged, 80 and over
• Carcinoma/mortality
• Carcinoma/pathology
• Female
• Humans
• Immunohistochemistry
• Kaplan-Meier Estimate
• Kidney Neoplasms/mortality
• Kidney Neoplasms/pathology
• Male
• Middle Aged
• Ureteral Neoplasms/mortality
• Ureteral Neoplasms/pathology

Lymphoepithelioma-like carcinoma (LELC) is a rare high-grade carcinoma that resembles nasopharyngeal lymphoepithelioma and can occur throughout the body. First reported in 1991, bladder LELC has an incidence of about 1% of all bladder carcinomas. Due to its rare occurrence, prognoses and ideal treatment guidelines have not been clearly defined.

A PubMed search was performed using two terms, “lymphoepithelioma-like carcinoma” and “bladder.” Review articles, articles in foreign languages, expression studies, and studies not performed in the bladder were excluded. We report a case of LELC of the bladder including treatment and outcome and performed a systematic review of all 36 available English literatures from 1991 to 2016 including the present case to identify factors affecting disease-free survival.

One hundred forty cases of bladder LELC were analyzed. The mean age of the patients was 70.1 years ranging from 43 to 90 years with 72% males and 28% females. Pure LELC occurs most often at 46% followed by mixed LELC 28% and predominant LELC 26%. EBV testing was negative in all cases tested. Mean follow-up length for all cases was 33.8 months with no evidence of disease in 62.2%, while 11.1% died of disease, 10.4% alive with metastasis, and 8.2% died without disease. 5.0% of cases had recurrence at an average of 31.3 months. Prognosis is significantly favorable for patients presenting with pure or predominant forms of LELC compared to mixed type (p < 0.0001). The treatment significantly associated with the highest disease mortality and lowest disease-free survival was TURBT alone when compared to any multi-modality treatment (p < 0.01).

We conclude that the best treatment modality associated with the highest disease-free survival is multi-modal treatment including radical cystectomy.

• Bladder tumor
• Case report
• Lymphoepithelioma-like carcinoma
• Systematic review

• Bladder carcinoma
• Bladder-preservation treatment
• Lymphoepithelioma-like carcinoma
• Prognosis of bladder carcinoma
• Urinary bladder

• Antineoplastic Combined Chemotherapy Protocols/therapeutic use
• Biomarkers, Tumor/analysis
• Carcinoma, Transitional Cell/diagnosis
• Carcinoma, Transitional Cell/drug therapy
• Carcinoma, Transitional Cell/pathology
• Cisplatin/administration & dosage
• Deoxycytidine/administration & dosage
• Deoxycytidine/analogs & derivatives
• Female
• Humans
• Middle Aged
• Urinary Bladder Neoplasms/diagnosis
• Urinary Bladder Neoplasms/drug therapy
• Urinary Bladder Neoplasms/pathology
• Gemcitabine

• Adenocarcinoma
• Gallbladder
• Lymphoepithelioma-like carcinoma

• Chosun University Hospital

Lymphoepithelioma-like carcinoma of the urinary bladder (LELCB) is a rare variant of infiltrating urothelial carcinoma. We report a case of LELCB in a 43-year-old man. Ultrasonography and cystoscopy revealed two bladder tumors, one on the left side of the trigone and the other on the right side of the trigone. Transurethral resection of the bladder tumors was performed and pathological analysis revealed undifferentiated carcinoma. We therefore performed radical cystectomy and urinary diversion. Immunohistochemically the tumor cells were positive for cytokeratin, but negative for Epstein-Barr virus-encoded small RNA in situ hybridization as found for previous cases of LELCB. The final pathological diagnosis was a lymphoepithelioma-like variant of urothelial carcinoma with perivesical soft tissue invasion. For adjuvant systemic chemotherapy, three courses of cisplatin were administered. The patient subsequently became free of cancer 72 months postoperatively. Based on the literature, pure or predominant LELCB types show favorable prognoses due to their sensitivity to chemotherapy or radiotherapy. An analysis of the apparent diffusion coefficient (ADC) values of bladder tumors examined in our institution revealed that the ADC value measured for this LELCB was relatively low compared to conventional urothelial carcinomas. This suggests that measuring the ADC value of a lymphoepithelioma-like carcinoma prior to operation may be helpful in predicting LELCB.

• Apparent diffusion coefficient value
• Epstein-Barr virus
• Lymphoepithelioma-like carcinoma
• Urinary bladder

• Carcinoma de células transicionales
• Carcinoma similar a un linfoepitelioma
• Diagnosis
• Diagnóstico
• Immunohistochemistry
• Inmunohistoquímica
• Lymphoepithelioma-like carcinoma
• Transitional cell carcinoma
• Urinary bladder
• Vejiga urinaria

Lymphoepithelioma is a malignant epithelial tumor in the nasopharynx characterized by prominent lymphoid infiltration. Carcinomas that resemble lymphoepitheliomas have been called lymphoepithelioma-like carcinomas and have been reported in other organs. A tumor in the bladder is categorized by the percentage of the total area occupied by the lymphoepithelioma-like carcinoma pattern, with the prognosis dependent on the percentage. We present an 81-year-old man with stage 3 chronic obstructive pulmonary disease and a history of aortic aneurysm repair. The computed tomography scans indicated thickening and irregularity of the bladder wall, with left external iliac lymph node metastasis. His diagnosis was bladder cancer, and the clinical stage was evaluated as T3N1M0. Transurethral resection of the bladder tumor was performed, and the pathological specimen showed that the tumor was composed of undifferentiated malignant cells with sheets and nests arranged in a syncytial pattern, as well as an urothelial carcinoma lesion. A prominent lymphoid reaction accompanied the tumor. The pathological diagnosis was focal-type lymphoepithelioma-like carcinoma containing a component of urothelial carcinoma G3>G2. His general condition was such that he could not tolerate radical cystectomy or systemic chemotherapy. External beam radiotherapy (total 60 Gy) was given to the bladder, including the lymph node metastatic lesion. No cancer recurrence was detected by regular follow-up computed tomography and cystoscopy. He eventually died of other causes 48 months later. Although treatment for focal lymphoepithelioma-like carcinoma generally requires multifocal therapies, in the present case, the bladder became tumor free. We also summarize previously reported lymphoepithelioma-like carcinoma cases treated with radiotherapy.

• Bladder cancer
• External beam radiotherapy
• Lymphoepithelioma-like carcinoma

Lymphoepitheliomas are malignant epithelial tumors of the nasopharynx characterized by an important lymphoid proliferation at histological examination. Lymphoepithelioma-like carcinoma is a rare tumor of the bladder for which the therapeutic strategy is not clearly defined.

We report the case of a 64-year-old Moroccan man who presented with macroscopic hematuria. Investigations revealed a muscle-invasive lymphoepithelioma-like carcinoma of the bladder. Therefore he underwent a radical cystoprostatectomy with a good outcome.

This case illustrates pathogenic, clinical and therapeutic features of this unusual tumor.

Lymphoepithelioma-like carcinoma is an undifferentiated carcinoma with histological features similar to undifferentiated, non-keratinizing carcinoma of the nasopharynx. Lymphoepithelioma-like carcinoma of the urinary bladder is uncommon with a reported incidence of 0.3%– 1.3% of all bladder cancer. We report a Japanese case of predominant lymphoepithelioma-like carcinoma of the urinary bladder and review all of the English literature after performing a pooled analysis of the cases including the present one.

An 83-year-old Japanese man was introduced to our department with the chief complaint of macroscopic hematuria. Cystoscopy demonstrated a thumb tip-sized bladder tumor at the trigone. The patient underwent a transurethral resection of the bladder tumor. The pathological examination showed predominant lymphoepithelioma-like carcinoma of the urinary bladder with urothelial carcinoma. The patient was diagnosed with muscle invasive lymphoepithelioma-like carcinoma of the urinary bladder and was treated with concurrent chemoradiotherapy. The patient is under observation with regular clinical follow-up and remains well after 12 months, with no evidence of disease recurrence. The reports of 93 patients including the present one of lymphoepithelioma-like carcinoma of the urinary bladder from the English literature were collected between 1991 and 2014. Patients were evaluated for clinicopathological findings. Outcome resulted as follows: 59 patients (67%) did not show evidence of disease, 14 (17%) died of disease, 5 (6%) was alive with metastases, and 9 (10%) died for causes unrelated to the primary disease. Cause-specific survival rate resulted 83%. The overall patients were divided into three groups (pure, predominant and focal) according to the lymphoepithelioma-like carcinoma of the urinary bladder classification of Amin et al.

Because lymphoepithelioma-like carcinoma of the urinary bladder is more sensitive to both chemotherapy and radiotherapy than conventional urothelial carcinoma, radical cystectomy may not be necessary for all patients with muscle invasive lymphoepithelioma-like carcinoma of the urinary bladder. Therefore, pathological information may be useful in selecting patients suitable for bladder-preservation treatment. On the other hand, the apparently more aggressive nature of focal lymphoepithelioma-like carcinoma of the urinary bladder suggests that these patients are probably best managed with radical cystectomy and adjuvant treatment.

Lymphoepithelioma is a very rare form of malignant tumor originating from epithelial line cells. Its occurrence has potential clinical, therapeutic and prognostic implications. In the present report we describe an unusual case of bladder cancer with two different histological varieties: transition cell carcinoma and lymphoepithelioma-like carcinoma. Lymphoepithelioma-like carcinoma of the bladder has only been rarely reported in the literature to date.

We present the case of a 68-year-old Caucasian man who, after occurrence of hematuria, underwent transurethral resection of a bladder tumor. The results of a histological examination confirmed a high-grade non-muscle-invasive pT1 lymphoepithelioma-like carcinoma of the urinary bladder, associated with a concurrent high-grade transition cell carcinoma. After analyzing the histological features, our patient was subjected to treatment with intra-vesical instillations of bacillus Calmette-Guérin. Our work stresses that diagnosis and therapeutic approaches can be difficult and controversial, especially in the early stages of this rare carcinoma.

This report emphasizes the importance of extending our knowledge and experiences regarding this uncommon carcinoma. Further studies are needed to better understand this rare disease and define more accurate diagnostic and therapeutic strategies.

We report a rare case of lymphoepithelioma-like hepatocellular carcinoma. A 79-year-old Japanese man had undergone curative resection of extrahepatic bile ducts because of bile duct cancer 9 years prior. The bile duct cancer was diagnosed as mucosal adenocarcinoma, and the patient had been followed up every 6 months for the last 9 years. A recent computed tomography examination revealed a tumor, 4.2 cm in size, in the lateral segment of the liver. Based on the imaging findings, the tumor was diagnosed as hepatocellular carcinoma. Serology tests were negative for hepatitis B and C viruses. Chest and abdominal image analyses showed no evidence of metastasis, but a swollen lymph node was noted around the abdominal aorta. The patient subsequently underwent extended lateral segmentectomy and resection of the swollen lymph node. Microscopically, the tumor had the characteristic appearance of poorly differentiated hepatocellular carcinoma. Moreover, an abundant infiltration of inflammatory cells was observed in the tumor. Therefore, we diagnosed the tumor as lymphoepithelioma-like hepatocellular carcinoma. The resected para-aortic lymph node also had a carcinoma with features similar to those of the main tumor. The patient has been alive for 20 months since performance of the surgery. Since the first report of lymphoepithelioma-like hepatocellular carcinoma in 2000, only nine cases have been reported in the medical literature, and the clinicopathological features of the disease have not been well documented. Herein, we describe the clinicopathological features of this case for further understanding of the disease and review past cases in the literature.

Lymphoepithelioma-like carcinoma (LELC) in the bladder is uncommon with a reported incidence of 0.4%–1.3% of all bladder carcinomas. In Japan, some occurrences of LELC have been reported in the renal pelvis and ureter but only two in the bladder. A bladder tumor was identified in a 70-year-old man suffering from macroscopic hematuria for 2 months. Sections of the transurethral tumor resection showed invasive high-grade urothelial carcinoma. The patient was diagnosed with local invasive bladder tumor, and cystectomy with ileal conduit formation was performed. The final pathological evaluation was predominant LELC with urothelial carcinoma. We present a new case of LELC in the bladder and performed a review of all published cases of LELC in the urinary tract to obtain its characteristics and prognostic guide.