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 | *Clear cells (at least focally). | ||
*Hobnailing | **Columnar or cuboidal morphology. | ||
**At least moderate [[nuclear pleomorphism]].<ref name=pmid23307189/> | |||
*Hobnailing (classic feature). | |||
Note: | Note: | ||
| Line 13: | Line 20: | ||
DDx: | DDx: | ||
*[[Nephrogenic adenoma]] - also has hobnailing. | *[[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 | *[[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== | ||
Latest revision as of 20:59, 13 November 2014
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:
- Muellerian rests or urothelium.[1]
- Shed kidney cells.[2]
- Nephrogenic adenoma - malignant transformation.[1]
Microscopic
Features:[1]
- Clear cells (at least focally).
- Columnar or cuboidal morphology.
- At least moderate nuclear pleomorphism.[2]
- Hobnailing (classic feature).
Note:
- Described as morphologically similar to clear cell adenocarcinoma of the gynecologic tract[2] - see clear cell carcinoma of the uterine cervix.
DDx:
- Nephrogenic adenoma[2][3] - 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
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
- ↑ 1.0 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.
- ↑ 2.0 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.