Clear cell adenocarcinoma with undifferentiated carcinoma conponent of the urinary bladder: A case report.

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Background: Clear cell carcinoma of the urinary bladder is extremely rare. We report cytological findings in an atypical case. Case: A 59-year old woman reported pollakiuria, macroscopic hematuria, and urinary obstruction. The biopsied specimen histologically indicated transitional cell carcinoma, G 3. Despite chemotherapy, the tumor did not shrink, so she was sent to our hospital. We found a fist-sized tumor on the posterior to anterior wall of the urinary bladder. Urinary cytology showed numerous atypical tumor cells with abundant clear or light green cytoplasm, eccentric nuclei, finely granulated chromatins, and small nucleoli. There were small vacuoles with light green globules in cytoplasm, and distinctive cytoplasmic rims. Multinucleated giant cells were also seen. Histologically, we diagnosed anaplastic tumor cells with multinucleated giant cells, well-differentiated adenocarcinoma of clear cells, and a hobnail pattern. Immunohistochemically, tumor cells were strongly positive for AE1/AE3, CAM 5.2, CK 7, EMA, and Leu M 1, and partially positive for S-100 protein, B 72.3, and PAP. Vimentin was positive in the anaplastic portion. Conclusion: In differential diagnosis, immunohistological and electronmicroscopical findings should be studied in addition to characteristic cytological features.
特定非営利活動法人日本臨床細胞学会の論文