Lymphoepithelial Carcinoma of the Sublingual Gland Associated with EBV Infection: A Case Report

舌下腺之淋巴上皮癌與相關聯的EB病毒感染：病例報告

林裕爲(Yu-Wei Lin) ； 林立青(Li-Ching Lin) ； 李健逢(Chien-Feng Li) ； 郭珍妮(Jenny Que) ； 林奎利(Kuei-Li Lin)

《放射治療與腫瘤學》 16卷1期 (2009/03) Pp. 69-78

https://doi.org/10.6316/TRO/200916(1)69

摘要

前言：淋巴上皮癌(lymphoepithelial carcinoma)是未分化癌的一種，是從鱗狀上皮細胞轉變而來的。在主唾液腺中，淋巴上皮癌是很少見的，尤其是在舌下腺，大部分都是侵犯腮腺。在格陵蘭島的愛斯基摩人及東南亞的人，有較高的盛行率，而且跟EB(Esptein-Barr virus)病毒的感染有相當的關聯。就我們所知，到目前為止並沒有醫學報告報導過舌下腺的淋巴上皮癌。
材料與方法：我們報告了第一個舌下腺之淋巴上皮癌，發生在一位37歲的台灣男性。一開始是以下頷腫塊來表現。正子斷層掃描證實這是一個侷限在區域的疾病，只影響左側的口腔底部跟下頷淋巴。同時鼻咽部並無侵犯。在血清學上，EBV VCA IgA及IgG都有上升。免疫組織化學染色上LMP-1也呈現陽性反應。病人先進行淋巴摘除術，再接續進行放射治療。
結果：在接受完放射治療後，腫瘤得到完全的緩解，並在20個月的追蹤下，沒有發現病人有復發或是轉移的現象。
結論，唾液腺的淋巴上皮癌在頭頸部的未分化癌中的預後是比較好。放射治療可以得到一個不錯的局部區域的控制率。因此放射治療對於初期或是手術後的病人可以提供一個良好的局部區域控制之治療。

關鍵字

淋巴上皮癌 ； 舌下腺 ； EB病毒 ； 唾液腺

並列摘要

Purpose: Lymphoepithelial carcinoma (LEC) is a subtype of undifferentiated carcinoma, which is originated from squamous cell. Lymphoepithelial carcinoma is a rare tumor of the major salivary gland, especially in sublingual gland. In moat cases, LEC affected the parotid gland. There are high incidences in Greenlandic Eskimos and Southeastern Asians with strongly associated with Epstein-Barr virus infection. To our knowledge, there is no case of LEC in sublingual gland reported in the medical literature.
Materials and Methods: We report the first case of LEC of the sublingual tumor of a 37-year-old Taiwanese man. The initial presentation was a mass over the submental area. PET/CT scan showed there was only a locoregional disease, which was limited in the left mouth floor and submental lymph node. Naopharynx was not involved at the same time. Serological studies showed elevated titer of Epstein-Barr virus: capsid antigen IgG and IgA antibodies. Immunohistochemical stain of LMP-1 also showed the positive result. The patient underwent excision and lymphodectomy followed by definite radiotherapy.
Result: Complete remission of LEC of the sublingual gland was achieved by the definite radiotherpy. The patient remained alive without any recurrence or metastasis after 20-month of follow-up.
Conclusion: LEC of the salivary gland is a radiosensitive disease and has a better prognosis among the undifferentiated carcinoma at the head and neck region. High rates of locoregional control were achieved by radiotherapy. Therefore, radiotherapy is appropriate locoregional therapy for patents in the early stage or after surgical intervention.

並列關鍵字

Lymphoepithelial carcinoma ； The sublingual gland ； EBV ； Salivary gland