J Korean Med Sci.  2008 Dec;23(6):1121-1124. 10.3346/jkms.2008.23.6.1121.

Clear Cell "Sugar" Tumor of the Lung: A Well-Enhanced Mass with an Early Washout Pattern on Dynamic Contrast-Enhanced Computed Tomography

• Kim WJ
• Kim SR
• Choe YH
• Lee KY
• Park SJ
• Lee HB
• Chung MJ
• Jin GY
• Lee YC

• KMID: 1107544
• DOI: http://doi.org/10.3346/jkms.2008.23.6.1121

Abstract

Clear cell tumor of the lung is a rare and very unusual benign pulmonary tumor. As clear cell tumor of the lung contains abundant cytoplasmic glycogen, this tumor is called "sugar tumor". We report a case of sugar tumor in a 64-yr-old man presenting as a round pulmonary nodule. On dynamic computed tomography (CT) scans, the solitary pulmonary nodule showed early wash-in enhancement with an early washout pattern like a lung malignancy. The patient underwent wedge resection for the tumor. Pathologic examination, including immunohistochemical studies, revealed that the nodule was a benign clear cell tumor, so-called "sugar tumor". Because only a small number of cases have been reported previously, clinical aspects, radiological characteristics on dynamic contrast-enhanced CT, and differential diagnosis of the tumor are not well established. Herein we present a clear cell tumor of the lung and discuss the clinical, radiological, and pathological features of the tumor.

Keyword

Clear Cell Tumor; Dynamic Contrast-Enhanced CT; Lung; Sugar Tumor; Washout Pattern

MeSH Terms

Antigens, Neoplasm/metabolism
Diagnosis, Differential
Humans
Lung/radiography/surgery
Lung Neoplasms/diagnosis/pathology/*radiography
Male
Middle Aged
Neoplasm Proteins/metabolism
Perivascular Epithelioid Cell Neoplasms/diagnosis/pathology/*radiography
Solitary Pulmonary Nodule/diagnosis/pathology/*radiography
*Tomography, X-Ray Computed

Figure

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  Fig. 1 Chest radiography (A) revealed an SPN in the left upper lobe. The dynamic contrast-enhanced chest CT (B) showed a well-enhanced SPN measuring 12×11×11 mm on anterior segment of left upper lobe in early phase with an early washout enhancement pattern (C). Each arrow in panel A and B indicates SPN.

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  Fig. 2 Macroscopic finding of the tumor. The tumor sized 12×10 mm was resected and easily enucleated. The tumor was nonencapsulated, well circumscribed, and grayish-white on cut surface.

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  Fig. 3 Representative hematoxylin and eosin stained sections of the lung mass at low magnification (A) and at high magnification (B). The tumor cells arranged in sheets or trabuculae separated by various sized thin-walled blood vessels. In addition, the tumor cells were polygonal with abundant clear to eosinophilic cytoplasm and distinct cytoplasmic membranes. In the immunohistochemical studies, the tumor cells showed strong immunoreactivity for HMB-45 (C).

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