Colon adenoma and adenocarcinoma with clear cell components - two case reports
Abstract 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. W...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-05-01
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| Series: | Diagnostic Pathology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13000-019-0819-z |
| _version_ | 1811262000535175168 |
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| author | Yuzo Oyama Haruto Nishida Takahiro Kusaba Hiroko Kadowaki Motoki Arakane Kazuhisa Okamoto Junpei Wada Shogo Urabe Tsutomu Daa |
| author_facet | Yuzo Oyama Haruto Nishida Takahiro Kusaba Hiroko Kadowaki Motoki Arakane Kazuhisa Okamoto Junpei Wada Shogo Urabe Tsutomu Daa |
| author_sort | Yuzo Oyama |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-12T19:15:51Z |
| format | Article |
| id | doaj.art-8c47057be2614324bd71df819021fa30 |
| institution | Directory Open Access Journal |
| issn | 1746-1596 |
| language | English |
| last_indexed | 2024-04-12T19:15:51Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Diagnostic Pathology |
| spelling | doaj.art-8c47057be2614324bd71df819021fa302022-12-22T03:19:44ZengBMCDiagnostic Pathology1746-15962019-05-011411810.1186/s13000-019-0819-zColon adenoma and adenocarcinoma with clear cell components - two case reportsYuzo Oyama0Haruto Nishida1Takahiro Kusaba2Hiroko Kadowaki3Motoki Arakane4Kazuhisa Okamoto5Junpei Wada6Shogo Urabe7Tsutomu Daa8Departments of Diagnostic Pathology, Faculty of Medicine, Oita UniversityDepartments of Diagnostic Pathology, Faculty of Medicine, Oita UniversityDepartments of Diagnostic Pathology, Faculty of Medicine, Oita UniversityDepartments of Diagnostic Pathology, Faculty of Medicine, Oita UniversityDepartments of Diagnostic Pathology, Faculty of Medicine, Oita UniversityDepartments of Gastroenterology, Faculty of MedicineDivision of Clinical Laboratory, Oita Prefectural HospitalDivision of Clinical Laboratory, Oita Prefectural HospitalDepartments of Diagnostic Pathology, Faculty of Medicine, Oita UniversityAbstract 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.http://link.springer.com/article/10.1186/s13000-019-0819-zColonAdenocarcinomaClear cell changeElectron microscopy |
| spellingShingle | Yuzo Oyama Haruto Nishida Takahiro Kusaba Hiroko Kadowaki Motoki Arakane Kazuhisa Okamoto Junpei Wada Shogo Urabe Tsutomu Daa Colon adenoma and adenocarcinoma with clear cell components - two case reports Diagnostic Pathology Colon Adenocarcinoma Clear cell change Electron microscopy |
| title | Colon adenoma and adenocarcinoma with clear cell components - two case reports |
| title_full | Colon adenoma and adenocarcinoma with clear cell components - two case reports |
| title_fullStr | Colon adenoma and adenocarcinoma with clear cell components - two case reports |
| title_full_unstemmed | Colon adenoma and adenocarcinoma with clear cell components - two case reports |
| title_short | Colon adenoma and adenocarcinoma with clear cell components - two case reports |
| title_sort | colon adenoma and adenocarcinoma with clear cell components two case reports |
| topic | Colon Adenocarcinoma Clear cell change Electron microscopy |
| url | http://link.springer.com/article/10.1186/s13000-019-0819-z |
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