PMC5960570_01
Macroscopic aspect of lymphoepithelioma-like carcinoma of the uterus. Polypoid tumor of 20 x 15 mm located in the fundus with areas of haemorrhage and necrosis.
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The tumor was soft, with areas of haemorrhage and necrosis, and invaded less than half of the myometrium (Figure 1).
Microscopic aspects of lymphoepithelioma-like carcinoma. At low power view, the endometrial tumor appeared as "bluish" relatively well limited with focal myometrial invasion (a). At high power view, note the syncytial aspect of the tumor nests and heavy infiltration of the stroma by lymphocytes and plasma cells closely intermingled with epithelial cells (b).
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An infiltration of the inner layers of the myometrium was observed (Figure 2).
Immunohistochemical aspect of lymphoepithelioma-like carcinoma. Positivity of epithelial component for cytokeratin AE1/AE3 (a) and in mirror of the stromal lymphocytes for CLA (b). Note that CD8+ cytotoxic T-lymphocytes are numerous (c). Strong nuclear expression of tumor cells for the p53 (d) and lesser for MLH1 (e). PDL1 expression was restricted to some stromal lymphocytes but the epithelial cells were negative (f).
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SAN27, 1 : 500, Leica Newcastle, United Kingdom), Vimentin (vim) (clone V9, 1 : 1000, Dako Glostrup, Denmark), p53 protein (strong nuclear staining) (clone DO-7, 1 : 200, Dako Glostrup, Denmark), MLH1 (MutL homolog 1) (clone ES05, 1 : 50, Leica Newcastle, United Kingdom), MSH2 (MutS homolog 2) (clone FE11, 1 : 50, Dako Glostrup, Denmark), MSH6 (MutS homolog 6) (clone EP49, 1 : 100, Dako Glostrup, Denmark), and PMS2 (postmeiotic segregation 2) (clone EP51, 1 : 100, Dako Glostrup, Denmark) (Figure 3). Stromal lymphoid cell showed a CLA (clone 2B11 + PD7/26, ready to use, Dako Glostrup, Denmark) positivity in mirror of epithelial component. PDL 1 (programmed death-ligand 1) (clone 22C3, ready to use, Dako Glostrup, Denmark) expression was negative in the epithelial component but scattered lymphocytes in peritumoral infiltrate were positive (Figure 3).