Hepatocellular Carcinoma - Clear Cell Pattern

Cellular variants of HCC include giant-cell forms with multinucleated tumor cells, spindle cell, sarcomatoid, and clear-cell types. In clear-cell HCC, cytoplasmic clearing may be due to fat, glycogen, or water. Clear-cell HCC should be differentiated from metastatic renal cell carcinoma, which is vimentin+, EMA+, pCEA negative, and (like HCC) usually CK7-/CK20-. Clear-cell HCC may have occasional intranuclear vacuoles (as in conventional HCC), focal pleomorphism (mild in this case), and scattered eosinophilic cytoplasmic globules (not seen here).