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Hospital  >  Departments  >  Laboratory Medicine  >  Anatomic Pathology  >  Gynecologic Pathology   >  Image Atlas  >  Cervix  >  3.0 Malignant and pre-malignant lesions  >  3.b.v Clear Cell Carcinoma

3.b.v Clear Cell Carcinoma

Clear Cell Carcinoma
Clear Cell Carcinoma
Clear Cell Carcinoma

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Historically, CCC of the cervix is well known because it used to be diagnosed in young women with in utero exposure to diethylstilbestrol (DES). Nowadays, CCC is a rare type of cervical carcinoma with sporadic occurrence and that has been linked to HPV infection in some cases (Ref 1). The prognosis of cervical CCC may be worse than that of conventional types of cervical carcinoma, but that remains uncertain.

The histological diagnostic features of cervical CCC are the same as that of CCC of the ovary and endometrium. Malignant cells usually have a clear cytoplasm, atypical nuclei and usually only have a low mitotic activity. CCC has a variety of architectural patterns, amongst which the tubulocystic pattern with hobnail nuclei protruding in the gland lumen is the hallmark of this tumor. The differential diagnosis of the tubulocystic pattern includes pregnancy-induced Arias-Stella phenomenon in which cells have a smudgy degenerated chromatin. CCC can also have a papillary architecture with thick hyalin cores covered by a single layer of malignant cells and therefore papillary CCC can be distinguished from serous carcinoma by the absence of cellular stratification and tufting. The diagnosis of CCC can be more challenging when it has a solid architecture and may be difficult to distinguish from an invasive squamous cell carcinoma; care should be given to look for the presence of keratinization, intercellular bridges or squamous intraepithelial lesions and areas that are more typical of either diagnosis.

Nofech-Mozes S, Khalifa MM, Ismiil N, Dubé V, Saad RS, Sun P, Seth A, Ghorab Z. Detection of HPV-DNA by a PCR-based method in formalin-fixed, paraffin-embedded tissue from rare endocervical carcinoma types. Appl Immunohistochem Mol Morphol. 2010 Jan;18(1):80-5. PMID: 19625948.


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Lesley Nicholson

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