CLEAR CELL ADENOMA:

Adenoma containing clear cells, usually intermigle with more traditional Adenoma.

Dear friends

Although there is some resemblance to a metastatic renal clear cell carcinoma the cytoplasm of the clear cells is finely vacuolated, not empty as is frequently the case in clear cells of renal carcinomas. The tubules around the clear cell focus are definitely dysplastic. Finally, all the images were shot from the very same focus, probably because that was the only clear cell focus present within the polyp.

With all these considerations my diagnosis is ADENOMA WITH CLEAR CELL CHANGE.

Sincerely

Romualdo Lins

Caruaru - Pernambuco

Brasil

Adenoma tubular con células claras. Bellísimas fotos y una verdadera curiosidad de caso.

Tubular Adenoma with clear cell change. Beatiful pictures and a truly rare case.

Suzuki H. et al . Adenoma with clear cell change of the large intestine. Journal of Surgical Oncology. 67(3):182, 1998.

Saludos!

Reynaldo Falcón-Escobedo´

San Luis Potosí, S.L.P.

MEXICO

ADENOMA WITH CLEAR CELL CHANGE

See also: Domoto H, Terahata S, Senoh A, Sato K, Aida S, Tamai S. Clear cell change in colorectal adenomas: its incidence and histological characteristics. Histopathology. 1999 Mar;34(3):250-6.

Un caro saluto a tutti e Buona Pasqua!

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It’s unquestionable the adenoma lesion. The problem is the clear cells that have architecture similar to the colonic mucosa without dysplasia. As the other colleges I thing It’s a Clear cell adenoma, but I thing It can be an association of Adenoma with a Clear cell Hyperplastic Polyp (Mixed hiperplastic poliyp / Adenoma) as you can see in the WHO Blue Book – Tumors of the digestive system – Page 136.

The graduation of intestinal polyps is always a point of had debate, that’s why I’d like to know the opinion of the colleges about the graduation of the dysplasia. Low grade or high grade dysplasia????

Túlio Geraldo de Souza e Souza

Depto. de Anatomia Patológica

Hospital Aliança - Salvador - BA

tulio@hospitalalianca.com.br

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Dear Tulio:

The base lesion of this interesting case corresponds with a classic colonic tubular adenoma and therefore by definition with low grade dysplasia. The clear cell change also corresponds -al least- with low grade dysplasia.

Adenoma Tubular con células claras.

Saludos. Que el amor y el sacrificio del Señor Jesucristo nos recuerde siempre el amor de nuestro Dios y Padre Celestial. El Señor los bendiga.

Esther.

Tubular adenoma with low-grade dysplasia and clear cell change.

AFIP Atlas of "Tumors of The Intestines", Third Series Fascicle 32, 2003 (p.11-113)

Tubular adenoma with clear cell change, low-grade dysplasia.

Clóvis Klock, MD

URI - CAMPUS DE ERECHIM

BRAZIL

Adenoma tubular de cèlulas claras

Acho que se trata de um adenoma tubular de baixo grau, com presença de células claras

Saludos

MIE

Clear cell tubular adenoma of the colon with low grade dysplasia

The eventually seen clear cell change in adenomatous polyps of large bowel, represents a histochemically debatable phenomen, as to wether representing glycogen, lipid or mucin cytoplasmic acumulation.

However, the high proliferative index (Ki-67/MIB-1 labeling index) and p53 overexpression, described in 1999 Histopath. paper, suggests that clear cell change is a phenotipic change thar may harbor more "prone to malignant evolution" biological behavior in comparision with the "typical" low-grade adenoma in the vicinity.

Abraço a todos. Feliz páscoa.

Kleber Simões.

A minha impressão é que se trata de um pólipo onde as células proliferantes, ao contrário do que habitualmente ocorre nos adenomas tubulares, se diferenciaram para um tipo terminal de célula da região, a célula mucosa mucossecretora (produtora de glicoproteína) com “microvacúolos” que na verdade são grânulos de secreção que não se coram com a HE, vistos claramente na última imagem. O aspecto sugere hiperplasia não ficando tão clara a idéia de displasia, uma vez que a diferenciação alcançou um tipo celular terminal de características maduras. Como as imagens parecem direcionar mais para o aspecto epitelial, não estando evidente o estroma para um exame mais detalhado fico com o diagnóstico de adenoma tubular.

Feliz Pascoa a todos.

I think this is a tubular adenoma with low grade dysplasia and clear cell change. I think it is usfel to examine other areas of the slide.