Primary Hepatoid Adenocarcinoma of the Lung

Hepatoid adenocarcinoma lung (HAL) is an extremely rare type of extrahepatic adenocarcinoma with morphological similarity to hepatocellular carcinoma. We report a case of 59 years male smoker who presented with anorexia, weight loss and cough. Chest X-ray revealed a homogenous opacity in the left upper and mid zone. Computed tomography (CT) chest showed a left upper lobe mass with enlarged hilar lymph nodes. Serum alpha fetoprotein (AFP) was normal. Guided fine needle aspi­ ration cytology (FNAC) of the mass revealed a few atypical cells. Endobronchial biopsy showed sheets of polygonal cells with coarsely clumped chromatin, eosinophilic nucleoli and abundant eosinophilic to clear cytoplasm. The neoplastic cells were positive for hepatocyte-1, Carcinogenic embryonic antigen (CEA), Cytokeratin 7 (CK-7) and cytoplasmic positivity for thyroid transcription factor (TTF-1). After 3 months, the tumor had grown significantly. Due to its aggressive behavior, early and accurate diagnosis is necessary.