An immunohistochemical study of benign clear cell ('sugar') tumor of the lung

Benign clear cell ("sugar") tumor is a rare and most unusual pulmonary neoplasm. Although several reports in the literature have focused on the ultrastructural features of benign clear cell tumor, only a few cases have been formally studied by immunochemistry. Using a broad panel of polyclonal and monoclonal antibodies, five cases were evaluated. In all five cases, there was diffuse immunoreactivity for cathepsin B. Four cases showed immunoreactivity for HMB-45 and for alpha 1-antitrypsin. By two different sources for antivimentin, there was immunoreactivity in four cases (Biogenex, Dublin, Calif) and in two cases (DAKO, Santa Barbara, Calif), respectively. Additional immunoreactivity was present for S100 protein (three cases), HAM-56 (two cases), factor XIIIA (two cases), and neuron-specific enolase (one case). No case expressed immunoreactivity for keratin (AE 1, AE 3, or CAM 5.2), carcinoembryonic antigen, chromogranin, synaptophysin, glial fibrillary acidic protein, or alpha 1-antichymotrypsin. This immunochemical profile suggests that HMB-45, in combination with a variety of immunostains, may serve to distinguish benign clear cell tumor from other clear cell neoplasms.