長期生存が確認された肺原発淡明細胞腺癌の1例

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  • A case of clear cell adenocarcinoma of the lung with long-term survival

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A 59-year-old man was admitted to our hospital with a 50×45-mm right apical segment tumor diagnosed by CT after a chest radiograph. After bronchoscopic cytologic diagnosis showed the adenocarcinoma, a right upper lobectomy and mediastinal lymph node dissection were performed. Histological examination showed the tumor to be well-circumscribed, containing more than 90% clear cells, and composed of solid nests and focal gland structures. A Periodic-acid Schiff (PAS) stain and a PAS with diastase pre-digestion (d-PAS) stain revealed intracellular glycogen and mucin in the glands. On immunohistochemical analysis, the tumor cells were positive for keratin (AE1/AE3), and only the surface of the lumina of the tumor glands was positive for CD10, but the tumor cells were negative for TTF-1, HMB-45, and vimentin. As other organs had no tumors, our final diagnosis was clear cell adenocarcinoma of the lung. Tegafur-uracil (UFT) was administered orally for 24 months as adjuvant chemotherapy, and the patient has survived for 6 years and 3 months since the surgical resection. We herein report a rare case of clear cell adenocarcinoma of the lung, and review the literature.

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