title: Clear cell hepatocellular carcinoma: Back to the basics for diagnosis.
abstract: Hepatocellular carcinoma (HCC) is a common cancer world-wide with a higher incidence in Asia. Clear cell variant of HCC (CCHCC) has a frequency ranging from 0.4% to 37%. The presence of 90-100% clear cells is rare. In the present case, a 35-year-old female patient presented with fever and a large abdominal mass in the right hypochondrium. Histology of the tumor revealed >95% clear cells and after taking multiple sections from different areas of tumor only few scattered cells with eosinophilic cytoplasm were found. Immunohistochemistry with Hep Par 1, Glypican 3 and polyclonal carcinoembryonic antigen were negative as were all other markers for metastatic clear cell tumors. Histological diagnosis was based on routine H and E sections showing a histological pattern of architecture with thickened trabeculae. We describe a rare case of CCHCC with >95% clear cells and no immunoreactivity in tumor cells in a non-cirrhotic liver.
authors.forename: Puja
authors.initials: P
authors.lastname: Sakhuja
authors.forename: Pramod K
authors.initials: PK
authors.lastname: Mishra
authors.forename: R
authors.initials: R
authors.lastname: Rajesh
authors.forename: Ashok Kumar
authors.initials: AK
authors.lastname: Sharma
authors.forename: Ranjana
authors.initials: R
authors.lastname: Gondal
authors.affiliation: Department of Pathology, GB Pant Hospital, New Delhi, India.
authors.forename: Meeta
authors.initials: M
authors.lastname: Singh
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000175:diagnosis / Q000473:pathology*; D000328:Adult; D014408:Biomarkers, Tumor / Q000235:genetics; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor