1. A Rare Case of Moderately Differentiated Adenocarcinoma With PD-L1 Overexpression and a Heterogeneous LELC Component in the Ascending Colon
- Author
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Nagano,Hideki, Watanabe,Takeshi, Togawa,Tamotsu, Ohnishi,Kenji, Kimura,Toshihisa, Iida,Atsushi, Sato,Yasunori, Goi,Takanori, Nagano,Hideki, Watanabe,Takeshi, Togawa,Tamotsu, Ohnishi,Kenji, Kimura,Toshihisa, Iida,Atsushi, Sato,Yasunori, and Goi,Takanori
- Abstract
Hideki Nagano,1 Takeshi Watanabe,1 Tamotsu Togawa,1 Kenji Ohnishi,1 Toshihisa Kimura,1 Atsushi Iida,1 Yasunori Sato,2 Takanori Goi3 1Department of Surgery, National Hospital Organization Tsuruga Medical Center, Fukui 914-0195, Japan; 2Department of Human Pathology, Kanazawa University, Graduate School of Medicine, Kanazawa 920-8640, Japan; 3First Department of Surgery, Faculty of Medicine, University of Fukui, Fukui 910-1193, JapanCorrespondence: Hideki Nagano Tel +81-776-25-1660Fax +81-770-25-7409Email naganohideki@nhofukui.orgBackground: Lymphoepithelioma-like carcinomas (LELCs), especially colorectal cancers (CRCs), are uncommon pathological phenotypes generally associated with poor aggressiveness and a preferable prognosis. However, PD-L1 overexpression in CRCs is associated with poor outcomes. We report a case of moderately differentiated adenocarcinoma with PD-L1 overexpression, an LELC component, and Crohn’s-like lymphoid reaction (CLR) presenting with extreme locoregional aggression and complete remission with chemotherapy after noncurative excision.Case presentation: A 69-year-old man was referred to our hospital for abdominal fullness and pain. Computed tomography (CT) showed a circumferential tumor in the ascending colon, accompanied by bulky swollen lymph nodes. Under the preoperative diagnosis of T4N2M1 (lymph nodes) ascending colon cancer, we performed a right hemicolectomy; however, paracaval and parailiac vein lymph nodes were abandoned. Pathological findings showed moderate to poorly differentiated adenocarcinoma invading the subserosa accompanied by an LELC component invading the superficial muscularis propria. Lymph node metastases were found in a neighboring tumor and in retroperitoneal lymph nodes with glandular differentiation. No relation to microsatellite instability (MSI) or Epstein-Barr virus (EBV) was observed. In the component with glandular differentiation, PD-L1 overexpression was revealed. CLR findings were also observed. The
- Published
- 2020