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Dermpath-India

Clear Cell Tumours of the Skin

Dr Sampurna Roy MD        

 

Epidermal-derived:

Clear cell acanthoma ; Bowen's disease ; Basal cell carcinoma

Adnexal tumours:

Paget's disease; Clear cell syringoma ; Clear cell hidradenoma   ;

Clear cell hidradenocarcinomaClear cell porocarcinoma ; clear cell myoepithelioma;

Tricholemmoma ; Tricholemmal carcinoma ; Sebaceous adenoma ; Sebaceous carcinoma.

Nevomelanocytic:

Balloon cell nevus ; Balloon cell melanoma ; Clear cell melanoma ; Clear cell sarcoma.

Mesenchymal:

Clear cell dermatofibroma; Clear cell atypical fibroxanthoma ; Clear cell fibrous papule.

Salivary gland:

Acinic cell carcinoma; Hyalinizing clear cell carcinoma ; Clear cell mucoepidermoid carcinoma.

Metastases:

Renal cell carcinoma ; Breast carcinoma ; Hepatocellular carcinoma ; Pulmonary adenocarcinoma and mesothelioma.

Clear cell carcinoma of Skin: 

1. Clear cell (hydropic) basal cell carcinoma and squamous cell carcinoma 

2. Clear cell variant of Atypical fibroxanthoma

3. Clear cell porocarcinoma         

4 Hidradenocarcinoma

5. Sebaceous carcinoma   

6. Trichilemmal carcinoma 

7. Metastatic clear cell adenocarcinoma of viscera (Example: Renal cell carcinoma)

8. Clear balloon cell malignant melanoma  
                                   
In malignant clear cell eccrine tumour, (Differential diagnosis - trichilemmal carcinoma), there is absence of peripheral palisading and presence of acinar or ductal differentiation that can be demonstrated by immunohistochemical stains for CEA.

In basal cell carcinoma and squamous cell carcinoma clear cells represent degenerative changes and may form epithelial lobules.

In sebaceous carcinoma the sebaceous cells display foamy cells with centrally located indented nuclei.

 

Immunohistochemical Panel

 

  Pan-keratin Ber-EP4  AE13/AE14

 

   EMA   CEA    CD68  S100
Clear cell basal cell carcinoma

 

   +     +      -     -      -      -    -
Clear cell squamous cell carcinoma

 

   +     -     -     +/-     -     -    -
Clear cell  variant of Atypical Fibroxanthoma

(positive for  vimentin & actins)

 

    -    -     -     -     -     +     -
Clear cell eccrine carcinoma     +    +/-      -      +     +/-     -    +/-
 

Sebaceous carcinoma

    +    +/-      -      +      -     -     -
 

Balloon  cell melanoma

    -    -     -      -      -     -     +
 

Trichilemmal carcinoma

    +    -     +     +/-     -     -      -
 

Metastatic clear cell adeno- carcinoma

Ca 125 or PLAP may be (+) 

 

     +    +/-     -      +    +/-      -     +/-

Further reading:

Cutaneous metastasis of renal cell carcinoma: a report of two cases.

Cutaneous metastatic breast carcinoma with clear cell features.

Cutaneous clear cell neoplasms: a histopathological reappraisal.

Clear cell variant of squamous cell carcinoma originating in the esophagus: report of a case with immunohistochemical and oncogenetic analyses.

Clear cell hidradenoma: a mimic of metastatic clear cell tumors.

Clear cell tumors of the skin.

Clear cell eccrine carcinomas of the skin . A clinicopathologic study of nine patients.  

Clear cell basal cell carcinoma an unusual degenerative variant:  

Clear cell carcinoma of the skin:  a trichilemmal carcinoma?

Clear cell tumours of the skin: a histopathological review:  

Clear cell carcinom of the skin. A variant of squamous cell carcinom that simulates sebaceous carcinoma

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 


 

 

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