Epstein-Barr virus-associated primary lymphoepitheliomalike carcinoma of the esophagus.

Primary lymphoepitheliomalike carcinomas (LELC) of the esophagus are uncommon, with only 29 previously reported cases in the literature. Primary LELC of the esophagus is associated with Epstein-Barr virus (EBV). We herein report a 52-year-old man who presented with dysphagia and weight loss and was found to have a polypoid mass in the middle esophagus. Pathologic examination showed LELC. EBV infection was demonstrated by immunohistochemical detection of EBNA-1 in neoplastic cells and polymerase chain reaction amplification for EBNA-3C, BamHI-F, and W1/I1 regions but not by in situ hybridization by EBER-1 transcripts. EBV genotyping analysis demonstrated infection by a novel type "i"/XhoI loss recombinant strain. Although it is accepted that polymorphisms at BamHI-W1/I1 region cosegregate with polymorphisms at XhoI restriction site, this novel recombinant EBV has been identified in healthy donors and in nasal NK/T-cell lymphoma. To our knowledge, this is the first report that describes this recombinant type "i"/XhoI loss EBV strain in a primary LELC of the esophagus.

[Macroglossia and occult amyloidosis]. / Macroglosia y amiloidosis oculta.

Amyloidosis is a rare disease characterized by the pathological deposit of extracellular proteins in organs or tissues. We report a 78 years old female with a history of euthyroid goiter and carpal syndrome, that presented complaining of weight loss and the sensation of a big and rough tongue. On physical examination, macroglossia and white nodules of 1.5 cm diameter in the mucosa of the mouth, were observed. The pathological examination of these nodules disclosed amyloid infiltration. A bone marrow biopsy showed plasma cell infiltration. The patient was treated with melphalan and prednisone, but she deteriorated progressively and died 14 months after the diagnosis.