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Vol.49 No.6 contents | Japanese/English |
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- Case Report -
A Large Cell Variant of Clear Cell Carcinoma of the Lung, Proven by Autopsy
Yoshihiro Kanemitsu1,2, Masahito Emura1, Takaya Nakamura1, Shigeki Sakai1, Yumi Sugio1, Takanori Cho11Division of Respiratory Medicine, Kyoto City Hospital, Japan, 2Division of Respiratory Medicine, Takatsuki Red Cross Hospital, Japan
Background. Clear cell carcinoma of the lung (CCCL) is a tumor predominantly consisting of clear cytoplasm. The incidence of CCCL is from 0.3 to 3.4 percent of all types of primary lung cancer. Case. A 66-year-old man was with hemodialysis for chronic renal failure presented with left hemiplegia and admitted to our hospital. Brain CT showed multiple masses and chest X-ray showed a mass in the apex of the left lung. Resection of the brain tumor was performed to improve his activities of daily living (ADL) and to make a diagnosis. Hematoxylin and eosin stain showed clear cytoplasm in the metastatic brain tumor cells with partial appearance of cluster of differentiation 10 (CD 10), which frequently develops with renal cancer immunohistochemically. We suspected brain metastasis of renal cell carcinoma from histological and immunohistochemical findings, although no mass was radiologically detected in the kidneys. The mass of the lung continued to enlarge in spite of interferon therapy, and as a result of the histologic study of the specimen obtained from CT-guided percutaneous biopsy, we regarded the tumor as CCCL. He died on the 102nd day. Autopsy revealed that the lung tumor was the largest of all the tumors, but no abnormalities were found in the kidneys. Pathologically the lung and metastasic tumors were mainly composed of cancer cells with clear cytoplasm and we diagnosed it as a large cell variant of CCCL without any signs of differentiation such as formation of cancer pearls, intercellular bridging or glandular configuration. Conclusion. We reported a large cell variant of CCCL, based on the autopsy-proven findings.
key words: Lung cancer, Clear cell carcinoma, Immunohistochemical stain
Received: October 6, 2008
Accepted: April 30, 2009
JJLC 49 (6): 847-851, 2009
