Lymphoepithelial Carcinoma, from the CureRays guide library.

Lymphoepithelial carcinoma is a rare cancer that looks and behaves like nasopharyngeal cancer, is often linked to the Epstein-Barr virus, and is notably sensitive to radiation, which (with chemotherapy) is the mainstay of treatment.

What it is.

Lymphoepithelial carcinoma is a rare cancer made of poorly differentiated (immature-looking) cancer cells intimately mixed with a heavy infiltrate of immune cells (lymphocytes) — an appearance identical to the most common cancer of the nasopharynx (the space behind the nose). When it arises outside the nasopharynx, it is called lymphoepithelial carcinoma or 'lymphoepithelioma-like carcinoma,' and it can occur in the salivary glands, tonsils, larynx, lung, stomach, skin, bladder, and other sites. Many cases — especially in the head and neck — are associated with the Epstein-Barr virus (EBV), the same virus tied to nasopharyngeal cancer; in some organs and populations it is not EBV-related. A key feature is that, like its nasopharyngeal counterpart, it is usually very sensitive to radiation and chemotherapy. Because of this, treatment often centers on radiation (frequently combined with chemotherapy) rather than extensive surgery, and outcomes are often better than the immature appearance of the cells might suggest.

How radiation treats it.

Radiation damages the DNA inside cancer cells so they can no longer divide and survive, while healthy cells repair themselves more effectively. Lymphoepithelial carcinoma is unusually sensitive to radiation, which means radiation — often combined with chemotherapy — can frequently cure the cancer while preserving the affected organ and avoiding major surgery. Treatment is delivered as a series of short, painless daily sessions, uses no radioactive implants, and leaves no radioactivity in your body, so you remain safe to be around family and children throughout.

The ways we can treat it.

Intensity-modulated radiation therapy (IMRT). Computer-shaped beams deliver a high, curative dose to the tumor and at-risk lymph nodes while sparing nearby organs such as salivary glands, the spinal cord, and the optic nerves.

Proton therapy. Proton beams stop at the tumor and deliver little dose beyond it, useful for tumors near the eyes, brain, or other sensitive structures, especially in the head and neck.

Concurrent chemoradiation. Radiation delivered alongside chemotherapy that sensitizes the cancer cells, increasing the chance of cure for node-positive disease.

Questions we hear often.

Is this the same as nasopharyngeal cancer? It looks the same under the microscope and behaves very similarly, but 'lymphoepithelial carcinoma' usually refers to this tumor when it arises outside the nasopharynx — for example in a salivary gland, the tonsil, or the lung. The shared biology means it responds to the same radiation-based treatments.

Why is the Epstein-Barr virus mentioned? Many of these cancers, especially in the head and neck, are linked to the Epstein-Barr virus, which is present in much of the population. The virus helps drive the tumor and can sometimes be used to monitor treatment, but it does not mean the cancer is contagious.

Why radiation instead of surgery? These tumors are unusually sensitive to radiation, so radiation — often with chemotherapy — can cure many of them while preserving the affected organ. Surgery is still the main treatment for some sites, but for head-and-neck disease, radiation is usually preferred.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.