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pulmonary clear cell adenocarcinoma

Sunday 30 September 2012

clear cell adenocarcinoma of the lung

Digital case

- JRC:6198 : Pulmonary clear cell adenocarcinoma.
- JRC:6200 : Pulmonary clear cell adenocarcinoma.

Synopsis

- Extremely rare as a pure subtype—but over a third of mixed adenocarcinomas show at least some focal clear cell change.
- Tumor cells form sheets with at least focal tubal formation (the latter required for diagnosis) and may form papillae.
- Intracytoplasmic material is PAS-positive, diastase-sensitive—indicative of glycogen.
- Pure tumors have not been well-studied by IHC—one reported tumor was CK7+/CK20-/TTF-1+.

Differential diagnosis

- Distinguishing primary lung clear cell adenocarcinoma from a renal metastasis requires

  • clinical and radiologic correlation
  • identifying a mixed growth pattern and intracytoplasmic mucin
  • finding IHC markers specific for RCC

See also

- pulmonary adenocarcinomas