Lymphoepithelioma‑like carcinoma of the uterine cervix: A case report with cytological findings

Uterine cervical lymphoepithelioma-like carcinoma (LELC) is a rare type of cervical squamous cell carcinoma (SCC). The present study describes a case of cervical LELC, including the cytological findings. A Japanese woman in her 40s was diagnosed with a high-grade squamous intraepithelial lesion (HSIL), suspected cytologically. The patient had previously tested positive for high-risk human papillomavirus (HPV). The cervical biopsy revealed findings that were indicative of HSIL/cervical intraepithelial neoplasia (CIN)2-3, and the patient was then referred to Tokyo Women's Medical University Hospital (Tokyo, Japan). A cervical cytological examination showed HSIL, and the presurgical cervical histological diagnosis was non-keratinizing SCC. Cervical conization was performed and the histopathological diagnosis was LELC. A cervical cytological specimen showed atypical cells with indistinct borders, enlarged round nuclei and a high nucleocytoplasmic ratio. Some cells had prominent nucleoli, and the tumor cells were intermingled with abundant neutrophils and lymphocytes. In addition, atypical squamous cells with orange G-philic cytoplasm and CIN-like atypical cells were observed, as well as clumps of atypical cells with thickened cytoplasm and a metaplastic appearance. The mechanism underlying the contributions of Epstein-Barr virus and/or HPV to the development of LELC is a topic for future investigation.