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A case of primary clear cell hepatocellular carcinoma in a non-cirrhotic liver: an immunohistochemical and ultrastructural study

Erica Fan Clayton, Emma Elizabeth Furth, Amy Ziober, Theodore Xu, Yuan Yao, Pil Gyu Hwang, Zhanyong Bing
  • Erica Fan Clayton
    Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
  • Emma Elizabeth Furth
    Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
  • Amy Ziober
    Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
  • Theodore Xu
    Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
  • Yuan Yao
    Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
  • Pil Gyu Hwang
    Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States
  • Zhanyong Bing
    Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, United States | bingz@uphs.upenn.edu

Abstract

The clear cell variant of hepatocellular carcinoma is a rare entity, occurring at a frequency of less than 10% of hepatocellular carcinoma, with a female prevalence and usually associated with hepatitis C and cirrhosis. We reported a case of primary clear cell hepatocellular carcinoma occurring in a non-cirrhotic liver without history of hepatitis. Our examination included gross pathology, histopathology, immunohistochemistry, special stains, and electron microscopy evaluation. The tumor was composed of sheets of medium-to-large cells with foamy and reticulated cytoplasm and small-to-medium sized nuclei with variably prominent nucleoli. Oil red O stain showed abundant intracellular lipid. Periodic Acid- Schiff stain confirmed the presence of abundant glycogen deposition. Immunohistoche - mically the tumor cells were positive for Hep Par1, negative for epithelial membrane antigen, steroidogenic factor-1, HMB45, melan A, CK7 and CK20. Electron microscopy study was performed, which was first done in a clear cell hepatocellular carcinoma occurring in a noncirrhotic liver without elevation of liver function tests. Ultrastructural evaluation of the clear cells showed scarce cellular organelles, cytoplasmic lipid vacuoles and swollen mitochondria.

Keywords

clear cell hepatocellular carcinoma; immunohistochemisty;ultrastructural study

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Submitted: 2011-10-31 19:58:52
Published: 2012-05-17 13:58:48
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Copyright (c) 2012 Erica Fan Clayton, Emma Elizabeth Furth, Amy Ziober, Theodore Xu, Yuan Yao, Pil Gyu Hwang, Zhanyong Bing

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