Clear cell tumor of the lung: A clinicopathologic, immunohistochemical, and ultrastructural study of eight cases

M. J. Gaffey, S. E. Mills, F. B. Askin, G. W. Ross, G. E. Sale, B. G. Kulander, D. W. Visscher, S. A. Yousem, T. V. Colby

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71 Scopus citations

Abstract

We studied eight clear cell tumors of the lung (CCTL) to better define their clinical, immunohistochemical, and ultrastructural features, and to clarify their distinction from other neoplasms, particularly metastatic renal cell carcinoma. Patients ranged in age from 31 to 67 years (mean, 51 years). Seven patients had clinically benign, asymptomatic lesions measuring less than 2 cm in diameter that were devoid of necrosis. The eighth patient had a symptomatic, partially necrotic CCTL 4.5 cm in diameter that metastasized to the liver and peritoneum; the patient died of tumor 17 years after diagnosis. Ultrastructural study of seven CCTL showed interdigitating cell processes (all cases), primitive cfell junctions (five of seven cases), intracytoplasmic glycogen (all cases), and rare dense core granules (two of seven cases). Immunohistochemically, paraffin-embedded sections from all eight CCTL were negative for cytokeratin (CK), epithelial membrane antigen (EMA), chromogranin, and vimentin. Focal staining was seen for S-100 protein (three of eight cases), neuron-specific enolase (three cases), synaptophysin (one case), and Leu 7 (one case). Although these findings suggest that at least some CCTL exhibit neuroendocrine differentiation, the tumor's histogenesis remains uncertain. Of more practical importance, the combined absence of CK, EMA, and vimentin in formalin-fixed, paraffin-embedded CCTL virtually precludes confusion with renal cell carcinoma. Although traditionally considered benign, CCTL larger than 2 cm that are symptomatic, and focally necrotic should be regarded as potentially malignant neoplasms.

Original languageEnglish (US)
Pages (from-to)248-259
Number of pages12
JournalAmerican Journal of Surgical Pathology
Volume14
Issue number3
DOIs
StatePublished - Jan 1 1990

Keywords

  • Clear cell tumor
  • Cytokeratin
  • Epithelial membrane antigen
  • Immunohistochemistry
  • Leu 7
  • Metastatic renal cell carcinoma
  • Neuron-specific enolase
  • S-100 protein
  • Sugar tumor
  • Synaptophysin
  • Vimentin

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

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    Gaffey, M. J., Mills, S. E., Askin, F. B., Ross, G. W., Sale, G. E., Kulander, B. G., Visscher, D. W., Yousem, S. A., & Colby, T. V. (1990). Clear cell tumor of the lung: A clinicopathologic, immunohistochemical, and ultrastructural study of eight cases. American Journal of Surgical Pathology, 14(3), 248-259. https://doi.org/10.1097/00000478-199003000-00006