Clear-cell carcinoma of the anal canal: A variant of anal transitional zone carcinoma

Watson, Peter H.; BChir,

doi:10.1016/0046-8177(90)90237-y

Cited by 14 publications

(4 citation statements)

References 5 publications

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“…Electron microscopic examination revealed multiple cytoplasmic lipid-like vacuoles in the clear cells of both cases, and this finding corresponded to previous reports [3, 5, 10–12]. These vacuoles were described as autolysis or elution of glycogen granules during processing or fixation [5, 10], glycogen-like material with lipid to a lesser extent [11], and degeneration due to lipid accumulation [6, 9]. Miyasaka et al [9] recently reported one case of TAC positive for adipophilin immunostaining and described that lipid accumulation might be responsible for its clear cell nature.…”

Section: Discussionsupporting

confidence: 90%

“…Both tumors showed a male predilection (adenoma: 11/17, adenocarcinoma: 18/23) and occurred mostly in the left-side colon (adenoma: 14/19, adenocarcinoma: 16/24). Some cases had multiple polyps at the same time [3, 7, 9, 11, 14, 16, 20] and two cases had multiple tubular adenomas with a clear cell component [7, 9]. Case 2 reported here had multiple polyps; however, no other polyps had clear cell components.…”

Section: Discussionmentioning

confidence: 84%

“…Case 1 is negative for those stains, in accord with previous TAC reports. In CCA, on the other hand, some cases are either positive for PAS [2, 11, 13, 15, 17, 21], Alcian blue staining [15], or AFP immunohistochemistry [21]; however, other cases are negative for these stains [3, 10, 12, 14, 19, 20, 26]. It seems that some heterogeneity exists among CCA cases [2, 3, 7, 10–26].…”

Section: Discussionmentioning

confidence: 99%

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Colon adenoma and adenocarcinoma with clear cell components - two case reports

et al. 2019

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Background Diagnoses reflect clear cell morphologies when tumor cells have clear cytoplasm in many organs, and the nature of such clear cells is typically identified. Colorectal tubular adenoma or adenocarcinoma, conversely, rarely show clear cells, the reason for which remains uncertain. We report 2 colon tumors with clear cell components (Case 1: adenoma; Case 2: adenocarcinoma) and investigate the nature of the clear cells. Case presentation Case 1 was a 75-year-old man with a superficial elevated polyp detected in the rectum for whom endoscopic submucosal dissection was performed. Microscopically, 10% of the tumor showed dysplastic columnar epithelium with clear cytoplasm forming tubular structures accompanied by conventional tubular adenoma. Case 2 was a 58-year-old man with a pedunculated polyp found in his sigmoid colon for which polypectomy was performed. Microscopically, 90% of the tumor showed dysplastic columnar epithelium with clear cytoplasm forming fused glands or cribriform structures adjacent to the ordinal tubular adenocarcinoma. In both cases, clear and ordinary tumor cells were negative for CK7 and positive for CK20 and CDX2, consistent with findings of colorectal origin. Different results were found for CEA and CD10 staining. CEA was positive on the luminal side of the conventional area in contrast diffuse cytoplasmic staining of the clear cell area in both cases. CD10 was only positive for the clear cell component of case 2. The clear cell components were negative for Periodic acid-Schiff (PAS), Alcian blue, and mucicarmine staining and AFP immunohistochemistry. An ultrastructural examination found multiple cytoplasmic lipid-like vacuoles in the clear cell component that were predominantly negative for adipophilin by immunoelectron microscopy. Conclusions We investigated tubular adenoma and tubular adenocarcinoma with clear cell components. The accompanying conventional tubular adenoma or adenocarcinoma cells helped us to evaluate the atypia of the clear cells. Diffuse cytoplasmic staining of CEA and CD10 suggested that the clear cell component might harbor malignant potential. We were unable to verify the well-known causes of clear cytoplasm, such as an accumulation of glycogen, lipid, or mucin and enteroblastic differentiation. The causes of clear cells in the colorectal region remain uncertain; however, possible explanations include autolysis and carbohydrate elution.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

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Colon adenoma and adenocarcinoma with clear cell components - two case reports

et al. 2019

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“…There are currently two types of CCCs; the intestinal type and the Müllerian type. Three diagnostic criteria are necessary to retain the intestinal type: the presence of colonic adenoma near the tumor or a composite tumor with a classic adenocarcinoma component, the absence of endometriotic lesions, and immunohistochemical expression of intestinal differentiation (CEA, CK20, CDX-2) [ 1 , 6 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Right Colon Clear Cell Carcinoma of Müllerian Type

Khefacha¹,

Triki²,

Ayed³

et al. 2022

Case Rep Gastroenterol

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Clear cell carcinoma (CCC) is usually seen in tissues originating from the paramesonephric (Müllerian) ducts such as the kidneys, the ovaries, the cervix and the vagina. The pathogenesis has not yet been elucidated. The diagnostic hallmark is the clear cytoplasm. Primitive CCC of the colon is a very rare entity. There are two types of CCC of the colon; the intestinal type and the Müllerien type. The differential diagnosis arises mainly with secondary metastases of renal or ovarian origin. Immunohistochemistry allows retaining the primitive character. The treatment is not yet consensual. It depends on the type of tumor and its stage. The treatment is based on surgery and possibly chemotherapy. We report the case of a 75-year-old female patient who underwent surgery for a tumor of the ascending colon. Microscopic examination concluded an extensively necrotic carcinomatous growth which infiltrated all the layers of the intestinal wall and the peritoneum. The tumor was made of clusters and spans of clear cells which were separated by thin conjunctivo-vascular septa. The tumor cells were round to polygonal with a clear, optically empty, pseudo-vegetative (physaliferous) cytoplasm. Immunohistochemistry study showed a positive staining with CK7 and a negative staining with CK20, CDX2, PAX8, P63, CD10, chromogranin, and synaptophysin. We performed a Medical Literature databases (Pubmed and Google Scholar) research. Only forty-two cases were reported in English literature. The main age is 55.7 (25–89). The sex ratio is one, but female cases were younger (52 vs. 61). The rectum is the most involved site. The left colon location is more frequent than the right one. The Müllerian type was found only at the level of the left colon and rectum. There was no CCC in the right colon of Müllerien type. The case we report herein is the first right colon CCC which is positive in CK7 staining.

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Malignant anal tumours

Deans

McAleer

Spence

1994

Journal of British Surgery

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Anal tumours represent 5 per cent of anorectal cancers and exist as two clinical entities: tumours of the anal canal and those of the anal margin. Smoking and sexual behaviour, particularly homosexual anal intercourse, are important aetiological factors. This association is related to anal warts and human papillomavirus infection, notably type 16, which is found in around 70 per cent of warts. Symptoms are non-specific and are frequently attributed to benign conditions. Rectal examination reveals a characteristically infiltrating lesion and any suspicious anal area should be biopsied. There are two histological types. Squamous carcinoma comprises approximately 95 per cent of anal tumours and includes the 35 per cent of tumours derived from the anal transition zone (cloacogenic tumours), containing a mixture of squamous and mucinous elements. The remaining 5 per cent of anal tumours are adenocarcinoma. Squamous cell tumours of the anal canal are probably best treated using radiotherapy (with chemotherapy) as complete response rates, 5-year survival rates, and incidences of normal sphincter function and significant toxicity are around 80, 70, 75 and 20 per cent respectively. Treatment failures may be salvaged by surgery. The 5-year survival and local recurrence rates for radical surgery are around 60 and 25 per cent respectively; there are few indications for local excision. In contrast, 60 per cent of anal margin tumours are suitable for local excision, the 5-year survival rate being in excess of 80 per cent. Combining radiotherapy with surgery may give additional benefit. Current randomized controlled trials should further clarify the relative merits and demerits of the treatment options.

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Clear-cell carcinoma of the anal canal: A variant of anal transitional zone carcinoma

Cited by 14 publications

References 5 publications

Colon adenoma and adenocarcinoma with clear cell components - two case reports

Colon adenoma and adenocarcinoma with clear cell components - two case reports

Right Colon Clear Cell Carcinoma of Müllerian Type

Malignant anal tumours

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