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      Lymphoepithelioma-Like Carcinoma of the Breast: A Case Report Unveiling Several Clinical and Histopathological Challenges

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          Abstract

          Lymphoepithelioma-like carcinoma (LELC) of the breast is an extremely rare tumor type. Histologically, it mimics undifferentiated nasopharyngeal carcinoma by demonstrating nests of neoplastic epithelial cells in a background of lymphoplasmacytic infiltrates. This paper reports a 62-year-old female patient with a 3 × 1.5 cm BI-RADS type IV breast mass diagnosed on excisional biopsy as LELC. The tumor is negative for estrogen and progesterone receptors and did not overexpress HER2/neu. Routine tests for clearance before surgery were performed, and patient was managed by a modified radical mastectomy with axillary lymph node dissection showing no residual tumor. Surgical CAse REports (SCARE) guidelines were followed for reporting our case. The rarity of LELC of the breast warrants the establishment and implementation of well-defined guidelines and criteria for diagnosis and management.

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          Most cited references32

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          The role of Epstein-Barr virus in lymphoepithelioma-like carcinomas.

          Epstein-Barr virus (EBV) has been implicated in the pathogenesis of a variety of lymphoproliferative disorders and several epithelial neoplasms, including undifferentiated nasopharyngeal carcinoma (UNPC; lymphoepithelioma). Lymphoepithelioma-like carcinomas (LEC) are tumors with morphologic features identical to UNPC that occur outside the nasopharynx. To determine whether EBV is associated with LEC, the authors conducted a comprehensive literature review of all pathologically documented LEC reported to date in the English literature. In summary, EBV is associated consistently with LEC from only four anatomic sites: stomach, salivary gland, lung, and thymus. Racial and/or geographic factors influence the association of EBV with LEC in some of these organs. Specifically, the association of EBV with LEC of the salivary gland and lung is restricted to Asian patients, whereas the association of EBV with gastric and thymic LEC is independent of race. The presence or absence of EBV in LEC does not appear to be prognotically important in those cases studies to date.
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            Medullary carcinoma of the breast: a clinicopathologic study with 10 year follow-up.

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              Breast MRI, digital mammography and breast tomosynthesis: comparison of three methods for early detection of breast cancer.

              Breast cancer is the most common malignancy in women and early detection is important for its successful treatment. The aim of this study was to investigate the sensitivity and specificity of three methods for early detection of breast cancer: breast magnetic resonance imaging (MRI), digital mammography, and breast tomosynthesis in comparison to histopathology, as well as to investigate the intraindividual variability between these modalities. We included 57 breast lesions, each detected by three diagnostic modalities: digital mammography, breast MRI, and breast tomosynthesis, and subsequently confirmed by histopathology. Breast Imaging-Reporting and Data System (BI-RADS) was used for characterizing the lesions. One experienced radiologist interpreted all three diagnostic modalities. Twenty-nine of the breast lesions were malignant while 28 were benign. The sensitivity for digital mammography, breast MRI, and breast tomosynthesis, was 72.4%, 93.1%, and 100%, respectively; while the specificity was 46.4%, 60.7%, and 75%, respectively. Receiver operating characteristics (ROC) curve analysis showed an overall diagnostic advantage of breast tomosynthesis over both breast MRI and digital mammography. The difference in performance between breast tomosynthesis and digital mammography was significant (p <0.001), while the difference between breast tomosynthesis and breast MRI was not significant (p=0.20).
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                Author and article information

                Contributors
                Journal
                Case Rep Surg
                Case Rep Surg
                CRIS
                Case Reports in Surgery
                Hindawi
                2090-6900
                2090-6919
                2018
                12 July 2018
                : 2018
                : 8240534
                Affiliations
                1Faculty of Medicine, American University of Beirut, Beirut, Lebanon
                2Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
                3Department of General Surgery, Hammoud Hospital University Medical Center, Saida, Lebanon
                4Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut, Lebanon
                5Department of Radiology, Hammoud Hospital University Medical Center, Saida, Lebanon
                6Department of Anatomy, Cell Biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
                7Department of Pathology, Hammoud Hospital University Medical Center, Saida, Lebanon
                Author notes

                Academic Editor: Piergiuseppe Colombo

                Author information
                http://orcid.org/0000-0003-1921-081X
                http://orcid.org/0000-0003-3799-2595
                http://orcid.org/0000-0003-2719-9921
                Article
                10.1155/2018/8240534
                6079566
                30123609
                59994a5e-433a-4743-9ae2-a73d91ddcefc
                Copyright © 2018 Tarek Aridi et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 April 2018
                : 7 June 2018
                Categories
                Case Report

                Surgery
                Surgery

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