Pulmonary lymphoepithelioma-like carcinoma with rapid progression.

Pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare entity, commonly associated in East Asia with Epstein-Barr virus (EBV) infection. A 71-year-old woman underwent partial resection of the left lower lobe for a 17-mm nodule and was subsequently diagnosed with pulmonary LELC. Six months postoperatively, chest computed tomography (CT) showed lymphadenopathy in the left hilum and a 16-mm nodule in the S6 segment of the left lower lobe that had been difficult to point out (3 mm in size) at the initial surgery. She underwent a second surgical resection because of rapid progression-a clinical course at variance with the generally good prognosis for pulmonary LELC. At admission, the EBV deoxyribonucleic acid (DNA) blood level was 40 copies/μg. The EBV DNA was undetectable after the second surgery.