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==General== | ==General== | ||
*Predominantly in women.<ref name=pmid24389164>{{Cite journal | last1 = Mehra | first1 = R. | last2 = Vats | first2 = P. | last3 = Kalyana-Sundaram | first3 = S. | last4 = Udager | first4 = AM. | last5 = Roh | first5 = M. | last6 = Alva | first6 = A. | last7 = Pan | first7 = J. | last8 = Lonigro | first8 = RJ. | last9 = Siddiqui | first9 = J. | title = Primary urethral clear-cell adenocarcinoma: comprehensive analysis by surgical pathology, cytopathology, and next-generation sequencing. | journal = Am J Pathol | volume = 184 | issue = 3 | pages = 584-91 | month = Mar | year = 2014 | doi = 10.1016/j.ajpath.2013.11.023 | PMID = 24389164 }}</ref> | *Predominantly in women.<ref name=pmid24389164>{{Cite journal | last1 = Mehra | first1 = R. | last2 = Vats | first2 = P. | last3 = Kalyana-Sundaram | first3 = S. | last4 = Udager | first4 = AM. | last5 = Roh | first5 = M. | last6 = Alva | first6 = A. | last7 = Pan | first7 = J. | last8 = Lonigro | first8 = RJ. | last9 = Siddiqui | first9 = J. | title = Primary urethral clear-cell adenocarcinoma: comprehensive analysis by surgical pathology, cytopathology, and next-generation sequencing. | journal = Am J Pathol | volume = 184 | issue = 3 | pages = 584-91 | month = Mar | year = 2014 | doi = 10.1016/j.ajpath.2013.11.023 | PMID = 24389164 }}</ref> | ||
Pathogenesis not well understood - may arise from: | |||
*Muellerian rests or [[urothelium]].<ref name=pmid24389164/> | |||
*Shed [[kidney tumours|kidney cells]].<ref name=pmid23307189/> | |||
*[[Nephrogenic adenoma]] - malignant transformation.<ref name=pmid24389164/> | |||
==Microscopic== | ==Microscopic== | ||
Features:<ref name=pmid24389164/> | Features:<ref name=pmid24389164/> | ||
*Clear cells | *Clear cells (at least focally). | ||
*Hobnailing | **Columnar or cuboidal morphology. | ||
**At least moderate [[nuclear pleomorphism]].<ref name=pmid23307189/> | |||
*Hobnailing (classic feature). | |||
Note: | Note: | ||
*similar to [[clear cell adenocarcinoma]] of the gynecologic tract - see ''[[clear cell carcinoma of the uterine cervix]]''. | *Described as morphologically similar to [[clear cell adenocarcinoma]] of the gynecologic tract<ref name=pmid23307189>{{Cite journal | last1 = Alexiev | first1 = BA. | last2 = Tavora | first2 = F. | title = Histology and immunohistochemistry of clear cell adenocarcinoma of the urethra: histogenesis and diagnostic problems. | journal = Virchows Arch | volume = 462 | issue = 2 | pages = 193-201 | month = Feb | year = 2013 | doi = 10.1007/s00428-012-1363-3 | PMID = 23307189 }}</ref> - see ''[[clear cell carcinoma of the uterine cervix]]''. | ||
DDx: | DDx: | ||
*[[Clear cell | *[[Nephrogenic adenoma]]<ref name=pmid23307189/><ref name=pmid21496868>{{Cite journal | last1 = Brimo | first1 = F. | last2 = Herawi | first2 = M. | last3 = Sharma | first3 = R. | last4 = Netto | first4 = GJ. | last5 = Epstein | first5 = JI. | last6 = Illei | first6 = PB. | title = Hepatocyte nuclear factor-1β expression in clear cell adenocarcinomas of the bladder and urethra: diagnostic utility and implications for histogenesis. | journal = Hum Pathol | volume = 42 | issue = 11 | pages = 1613-9 | month = Nov | year = 2011 | doi = 10.1016/j.humpath.2011.01.007 | PMID = 21496868 }}</ref> - also has hobnailing, not mitotically active, no necrosis, no or mild [[nuclear atypia]]. | ||
*[[Clear cell renal cell carcinoma]]. | |||
* | *[[Clear cell adenocarcinoma]] of the gynecologic tract. | ||
*Other [[clear cell tumours]]. | |||
===Images=== | ===Images=== | ||
www: | www: | ||
*[http://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=3936309_gr1.jpg CCA of the urethra (nih.gov)].<ref name=pmid24389164/> | *[http://www.ncbi.nlm.nih.gov/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Click%20on%20image%20to%20zoom&p=PMC3&id=3936309_gr1.jpg CCA of the urethra (nih.gov)].<ref name=pmid24389164/> | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3479785/figure/F3/ CCA of the urethra (nih.gov)].<ref>{{Cite journal | last1 = Han | first1 = JY. | last2 = Kim | first2 = KH. | last3 = Kim | first3 = L. | last4 = Choi | first4 = SJ. | last5 = Park | first5 = IS. | last6 = Kim | first6 = JM. | last7 = Chu | first7 = YC. | last8 = Yoon | first8 = SM. | title = Cytologic findings of clear cell adenocarcinoma of the urethra: a case report. | journal = Korean J Pathol | volume = 46 | issue = 2 | pages = 210-4 | month = Apr | year = 2012 | doi = 10.4132/KoreanJPathol.2012.46.2.210 | PMID = 23110004 }}</ref> | |||
==IHC== | ==IHC== | ||
Features: | Features:<ref name=pmid23307189/> | ||
*PAX8 +ve. | *PAX8 +ve/-ve (2 +ve in 4 cases. | ||
*CK7 +ve. | *CK7 +ve/-ve (2 +ve in 4 cases). | ||
*Vimentin +ve (3 +ve in 4 cases). | |||
*CK20 -ve/+ve (1 +ve in 4 cases). | |||
Others: | Others:<ref name=pmid23307189/> | ||
*ER -ve. | *ER -ve. | ||
*p63 -ve. | *p63 -ve. | ||
*[[PSA]] -ve. | |||
*p16 -ve. | |||
*Ki-67 ~ 47/200 on average cells. | |||
**5.5/200 cells on average in nephrogenic adenoma.<ref name=pmid9865832>{{Cite journal | last1 = Gilcrease | first1 = MZ. | last2 = Delgado | first2 = R. | last3 = Vuitch | first3 = F. | last4 = Albores-Saavedra | first4 = J. | title = Clear cell adenocarcinoma and nephrogenic adenoma of the urethra and urinary bladder: a histopathologic and immunohistochemical comparison. | journal = Hum Pathol | volume = 29 | issue = 12 | pages = 1451-6 | month = Dec | year = 1998 | doi = | PMID = 9865832 }}</ref> | |||
==See also== | ==See also== |
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