Difference between revisions of "Clear cell adenocarcinoma of the urethra"

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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 - at least focally.
*Clear cells (at least focally).
*Hobnailing - classic feature.
**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 tumours]].
*[[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 adenocarcinoma]] of the gynecologic tract.
*[[Clear cell renal cell carcinoma]].
**[[Clear cell renal cell carcinoma]].
*[[Clear cell adenocarcinoma]] of the gynecologic tract.
**Others.
*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/>
*CK20 -ve.
*ER -ve.
*ER -ve.
*PR -ve.
*p53 -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==

Latest revision as of 19:38, 18 June 2024

Clear cell adenocarcinoma of the urethra, also primary urethral clear cell adenocarcinoma, is a very rare malignant tumour of the urethra.

General

  • Predominantly in women.[1]

Pathogenesis not well understood - may arise from:

Microscopic

Features:[1]

  • Clear cells (at least focally).
  • Hobnailing (classic feature).

Note:

DDx:

Images

www:

IHC

Features:[2]

  • PAX8 +ve/-ve (2 +ve in 4 cases).
  • CK7 +ve/-ve (2 +ve in 4 cases).
  • Vimentin +ve (3 +ve in 4 cases).
  • CK20 -ve/+ve (1 +ve in 4 cases).

Others:[2]

  • ER -ve.
  • p63 -ve.
  • PSA -ve.
  • p16 -ve.
  • Ki-67 ~ 47/200 on average cells.
    • 5.5/200 cells on average in nephrogenic adenoma.[5]

See also

References

  1. 1.0 1.1 1.2 1.3 1.4 Mehra, R.; Vats, P.; Kalyana-Sundaram, S.; Udager, AM.; Roh, M.; Alva, A.; Pan, J.; Lonigro, RJ. et al. (Mar 2014). "Primary urethral clear-cell adenocarcinoma: comprehensive analysis by surgical pathology, cytopathology, and next-generation sequencing.". Am J Pathol 184 (3): 584-91. doi:10.1016/j.ajpath.2013.11.023. PMID 24389164.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 Alexiev, BA.; Tavora, F. (Feb 2013). "Histology and immunohistochemistry of clear cell adenocarcinoma of the urethra: histogenesis and diagnostic problems.". Virchows Arch 462 (2): 193-201. doi:10.1007/s00428-012-1363-3. PMID 23307189.
  3. Brimo, F.; Herawi, M.; Sharma, R.; Netto, GJ.; Epstein, JI.; Illei, PB. (Nov 2011). "Hepatocyte nuclear factor-1β expression in clear cell adenocarcinomas of the bladder and urethra: diagnostic utility and implications for histogenesis.". Hum Pathol 42 (11): 1613-9. doi:10.1016/j.humpath.2011.01.007. PMID 21496868.
  4. Han, JY.; Kim, KH.; Kim, L.; Choi, SJ.; Park, IS.; Kim, JM.; Chu, YC.; Yoon, SM. (Apr 2012). "Cytologic findings of clear cell adenocarcinoma of the urethra: a case report.". Korean J Pathol 46 (2): 210-4. doi:10.4132/KoreanJPathol.2012.46.2.210. PMID 23110004.
  5. Gilcrease, MZ.; Delgado, R.; Vuitch, F.; Albores-Saavedra, J. (Dec 1998). "Clear cell adenocarcinoma and nephrogenic adenoma of the urethra and urinary bladder: a histopathologic and immunohistochemical comparison.". Hum Pathol 29 (12): 1451-6. PMID 9865832.