Primary Lymphoepithelioma-Like Carcinoma of the Conjunctiva Metastatic to Regional Lymph Nodes and Parotid Gland in a Mexican Patient

Figure 2

Photomicrographs of histopathological and immunohistochemical findings. (a, b) Different portions of the eyelid are involved in their entire thickness, by a malignant neoplasm composed of sheets, syncytia, and solid nests of cells with epithelioid appearance with moderate amount of eosinophilic cytoplasm with poorly differentiated borders and round to oval vesicular nuclei with one or two nucleoli and numerous typical and atypical mitoses. The nests of neoplastic cells are intermingled with areas of coagulative necrosis and surrounded by inflammatory infiltrate composed of lymphocytes and plasma cells. The superficial epithelium is ulcerated in the majority of its extent (H&E, original magnification 10x and 40x). (c–f) Immunohistochemistry with primary antibodies against epithelial membrane antigen (EMA), pan-cytokeratin AE1/AE3, and cytokeratin 5/6 (CK5/6) was positive for neoplastic cells. Latent membrane protein 1 (PML-1) was negative (ruling out association with EBV infection) as well as HMB45 (ruling out melanoma).

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