Histopathology

A monomorphous population of polygonal to round cells with clear cytoplasm characterizes clear cell carcinomas. In some cases, a minority of cells have pale eosinophilic cytoplasm. Nuclei are eccentric and round and frequently contain small nucleoli. PAS staining with and without prior diastase digestion of the tissue demonstrates cytoplasmic glycogen that varies from marked to not evident. The adjective glycogen-rich has been used by some to identify clear cell carcinomas with a prominent glycogen content {1028,2658}. With mucicarmine stain, intracytoplasmic mucins are usually absent. The tumour cells are arranged in sheets, nests, or cords, and ductal structures are absent. Mitotic figures are rare, but some tumours have a moderate degree of nuclear pleomorphism. In the hyalinizing type, the stroma is composed of thick bands of hyalinized collagen {727,1728}, but in other tumours it consists of interconnecting, thin fibrous septa that may be cellular or loosely col-lagenous. Clear cell carcinomas are unencapsulated and infiltrative.

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