Lymphoepithelioma-like carcinoma of the Bartholin gland

The authors report a case of lymphoepithelioma-like carcinoma originating in the Bartholin's gland in a 52-year-old woman. The tumor showed distinct morphologic features including variably sized and shaped nodules and syncytial sheets of large epithelial cells that contained large round nuclei with vesicular chromatin and prominent nucleoli and that were permeated and surrounded by small, well-differentiated lymphocytes and plasma cells. Focally, the neoplastic nodules blended with residual acini of the Bartholin gland. In the transitional areas, there were few acini that evidenced squamous cell metaplasia with partial or complete replacement of mucinous cells by squamous epithelium that showed dysplastic changes. In addition, some ducts in the transitional areas manifested lymphocyte infiltration of their walls. The uninvolved residuum of the Bartholin gland was unremarkable except for a few ruptured ducts or acini with extravasated stromal mucin. Immunohistochemically, the tumor cells were positive for p16, as were acini with metaplastic and dysplastic changes. Neither Epstein-Barr virus nor human papillomavirus was identified in the lesional tissue by polymerase chain reaction. This seems to be the first full-documented report of lymphoepithelioma-like carcinoma originating in the Bartholin gland.