Fine needle aspiration cytology of clear cell carcinoma of the gallbladder with hepatic infiltration: a case report.
BACKGROUND
Clear cell carcinoma of the gallbladder (CCG) is an unusual histologic variant recognized in the World Health Organ ization classification of tumors of the gallbladder and extrahepatic bile ducts. Although the clinicopathologic features have been documented in a few reports, to our knowledge the cytologic findings have not been described before. We report the fine needle aspiration cytology (FNAC) findings in a case of CCG with hepatic infiltration.


METHODS
A 72-year-old woman presented with right upper quadrant pain and hepatomegaly. Serum levels of CA19-9 and alpha-fetoprotein were elevated. Computed tomography revealed several hepatic nodules, the larger of which was a mass in contact with the gallbladder, which had a thickened wall. FNAC showed loose sheets and disassociated cells with abundant, clear, finely vacuolated cytoplasm. Atypical bare nuclei, binucleated cells and some multinucleated cells were also found. A simultaneous trucut biopsy from the main hepatic mass confirmed the diagnosis.


CONCLUSIONS
CCG is a clear cell neoplasm that should be considered when clear changes are observed on FNAC. Recognition of the cytologic features, together with adequate clinicoradiologic study, may be sufficient to establish the diagnosis.
Department of Pathology, General Hospital, Soria, Spain.
Agustín
A
Vaíllo
Francisco Javier
FJ
Rodríguez-Recio
Antonia
A
Gutiérrez-Martín
Claudio
C
Ballestín
Juan Manuel
JM
Ruiz-Liso
D018262:Adenocarcinoma, Clear Cell / Q000097:blood / Q000556:secondary* / Q000628:therapy; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D044963:Biopsy, Fine-Needle; D018395:CA-19-9 Antigen / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D005260:Female; D005706:Gallbladder Neoplasms / Q000097:blood / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary* / Q000628:therapy; D009361:Neoplasm Invasiveness; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000032:analysis
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D000509:alpha-Fetoproteins