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Table of Contents
Definition / general | Terminology | Epidemiology | Etiology | Clinical features | Case reports | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosisCite this page: Clear cell carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/uterusclearcell.html. Accessed July 16th, 2017.
Definition / general
- Tumor of post-menopausal patients that histologically resembles ovarian clear cell carcinoma with clear or hobnail cells
- ICD-O: 8310/3
Terminology
- Also called clear cell carcinoma
Epidemiology
- 1% - 5% of all endometrial adenocarcinoma
- Usually older, postmenopausal women
Etiology
- A type II tumor (estrogen independent)
- Arises from atrophic endometrium (not endometrial hyperplasia), similar to serous carcinoma
Clinical features
- High grade tumors (automatically FIGO grade III) with aggressive behavior
- Poorer prognosis than high grade (grade 3) endometrioid adenocarcinoma (Br J Cancer 2006;94:642)
- If confined to corpus, has better prognosis than serous carcinoma of same stage
Case reports
- 73 year old woman with tumor arising from adenomyosis (Int J Gynecol Pathol 2009;28:262)
Microscopic (histologic) description
- Papillary, tubular, tubulocystic or sheet-like architecture
- Large, clear to rarely eosinophilic cells with glycogen, distinct margins and hobnail cells
- May have colloid-like material in tubules
- Enlarged angulated nuclei with enlarged irregular nucleoli
- Usually associated with a putative precursor lesion of isolated glands or surface epithelium (within an otherwise normal endometrial region) that displays cytoplasmic clarity or eosinophilia with varying degrees of nuclear atypia (Am J Surg Pathol 2006;30:1519)
- Benign endometrium is usually atrophic, not hyperplastic
Microscopic (histologic) images
Images hosted on PathOut server:
Solid sheet of tumor cells with voluminous clear cytoplasm
Predominantly papillary growth
growth (left) blends
with a more solid
pattern (right)
Tubuloglandular growth
with nuclear pleomorph-
ism; both clear and hob-
nail cells are present
A solid focus of tumor is composed of cells
with pleomorphic, hyperchromatic nuclei,
each with one or more prominent nucleoli;
voluminous clear cytoplasm is present
This field shows cellular stratification, voluminous
clear cytoplasm, and bizarre, occasionally multiple
nuclei resembling Arias-Stella change; at lower magnifi-
cation, this was an obviously invasive malignant tumor
Images hosted on other servers:
p53 staining (figure 6)
Positive stains
- Hepatocyte nuclear 1 beta (Hum Pathol 2007;38:1074), Ki67 (Hum Pathol 1998;29:551)
Differential diagnosis
- Clear cell carcinoma of ovarian origin
- Clear cell change: no invasion, no atypia
- Endometrial EIN / atypical hyperplasia with clear cell change: not invasive, clear cells lack atypia (Ann Diagn Pathol 2003;7:381)
- Metastatic renal cell carcinoma
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