Seon Young Park MD, Presenter: Nothing to Disclose

Young Chul Kim MD, Abstract Co-Author: Nothing to Disclose

Tae Sun Han, Abstract Co-Author: Nothing to Disclose

Young Keun Sur MD, Abstract Co-Author: Nothing to Disclose

Jei Hee Lee MD, Abstract Co-Author: Nothing to Disclose

Jai Keun Kim MD, Abstract Co-Author: Nothing to Disclose

Primary gastric lymphoepithelioma-like carcinoma (LELC) is a rare type of undifferentiated gastric adenocarcinoma with better prognosis than the conventional gastric adenocarcinoma. We analyzed the clinical and radiologic features of Epstein-Barr virus (EBV)-associated LELC to determine the computed tomography (CT) features that differentiate it from conventional gastric adenocarcinoma.

Between January 2004 and December 2012, clinical and radiologic features of 39 EBV-associated LELCs were compared with that of 36 conventional gastric adenocarcinomas. Independent t-test was used to evaluate the difference in patient age between EBV-associated LELC and conventional gastric adenocarcinoma. Sexual distribution, lesion detectability, multiplicity, presence of lymph node metastasis, location, gross appearance, lesion thickness and margin, presence of round edge, contrast enhancement pattern, and degree of contrast enhancement were compared using Chi-square test.

Male predominance (male to female ratio=31:8) was seen in patients with EBV-associated LELC with statistical significance (p < 0.001). The most common location of EBV- associated LELC was the upper third of the stomach with statistical significance (p=0.0001). There was a statistically significant difference in the presence of uniform peripheral thickness between both groups; 30 patients (88.24%) with EBV- associated LELCs and 13 (40.63%) with conventional gastric adenocarcinomas (p=0.001). EBV - associated LELCs demonstrated well-defined margins (n=29; 85.29%) more often than conventional gastric adenocarcinomas (n=19, 59.37%; p=0.0369). There was a statistically significant difference in the presence of a round edge between both groups; 25 patients (73.53%) with EBV- associated LELCs and 15(46.87%) with conventional gastric adenocarcinomas (p=0.0497).

The radiologic features including tumor location in the upper third of the stomach and, presence of uniform peripheral thickness with round edge (“pizza crust sign”) can be helpful in differentiating EBV- associated LELC from conventional gastric carcinoma on CT scans.

Clinical and radiologic features of EBV-associated LELC in out study can be helpful in differentiating EBV-associated LELC from conventional gastric carcinoma on CT scans.  

Park, S, Kim, Y, Han, T, Sur, Y, Lee, J, Kim, J, Comparative Imaging Analysis of Epstein - Barr Virus-associated Gastric Lymphoepithelioma-like Carcinoma versus Conventional Gastric Adenocarcinoma.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14006272.html