Liver & intrahepatic bile ducts
Hepatocellular carcinoma
HCC - clear cell variant
Author: Deepali Jain, M.D.
Last author update: 1 February 2012
Last staff update: 25 July 2022
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Clear cell hepatocellular carcinoma
Table of Contents
Definition / general | Clinical features | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Jain D. HCC - clear cell variant. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/livertumorclearcellHCC.html. Accessed April 24th, 2024.
Definition / general
- Predominant appearance of neoplastic hepatocytes with abundant clear cytoplasm
- Predominant in 5 - 16% of cases but some clear cells present in 20 - 40% of cases
- Clear cytoplasm is due to cytoplasmic fat or glycogen
- May need to hunt for typical hepatocellular carcinoma to rule out metastatic tumor
Clinical features
- Elevated serum AFP (92%), may have hypoglycemia or hypercholesterolemia
- Similar prognosis as classic hepatocellular carcinoma (World J Gastroenterol 2010;16:764)
Microscopic (histologic) description
- Trabecular, pseudoacinar, solid or mixed patterns of large number of neoplastic hepatocytes with abundant clear cytoplasm (glycogen or lipid) and round nuclei
- May have bland nuclear features
- May have intracytoplasmic bile (5 - 33%)
- Usually no intratumoral fibrosis except in areas of hemorrhage and necrosis
- Must distinguish from HCC variant with foamy histiocytes (Case Rep Gastroenterol 2010;4:286)
Microscopic (histologic) images
Contributed by Jaime A. Mejía, M.D.
Clear cell hepatocellular carcinoma
Images hosted on other servers:
Various images
Positive stains
- Polyclonal CEA (canalicular pattern, 63%), HepPar1 (82 - 97%, Mod Pathol 2000;13:874)
- ISH for albumin mRNA (93%, Am J Surg Pathol 2000;24:177)
- Ubiquitin (for Mallory bodies)
Differential diagnosis
- Balloon cell melanoma:
- Clear cell neuroendocrine tumors:
- Epithelioid angiomyolipoma:
- Metastatic renal (PAX2+, EMA+), adrenal (inhibin+, MelanA+, calretinin+) or ovarian carcinoma:
- No classic hepatocellular carcinoma present
