Clear cell adenocarcinoma of the urethra
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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.