Clear Cell Variant Squamous Cell Carcinoma of the Lung-A Case Report

Abstract

Clear cell change in primary lung cancer is not uncommon, but clear cell-predominant bronchogenic carcinoma is extremely rare. The unique pathologic character of clear cells is large polygonal tumor cells with ”water-clear” or foamy cytoplasm. Most of the reports had a favorable prognosis. A 72-year-old male was seen with persistent dry cough; chest radiography revealed a left upper lobe mass. After a detailed survey, left upper lobe lobectomy and lymph node dissection were performed. Clear cell changes were found on nearly all pathologic sections and only few tiny squamoid differentiations were found. Clear cell variant of squamous cell carcinoma was the final diagnosis. The patient had an early local recurrence and chest wall metastasis after 6 months which was a quite unusual clinical course. The presentation of majority clear cells of lung cancer required a complete review of all pathologic sections to find any squamous or glandular differentiation. Benign sugar tumors and metastasis from urinary tract malignancy should also be differentiated both by immunohistochemical stains and detailed radiographic survey.