Case 56

A 56 year old male with history of long term smoking presented with hematuria. Here is the TURBT specimen:

1. What IHC you would like to see in this tumor?

   
   

IHC

• GATA3
• CK20, CK7
• p63
• PAX8

See All Options

Answer

The tumor is weakly but diffusely positive for GATA3 and very focally positive for p63 and uroplakin 2. Immunostains for PAX8, Napsin a and WT1 are negative.

2. Based on the IHC profile and mophology features, what diagnosis you would favor?

   A: Clear cell adenocarcinoma

   B: Metastatic carcinoma with clear cell features

   C: Clear cell sarcoma

   D: Urothelial Carcinoma with clear cell features

Answer

The correct answer is D. Clear cell adenocarcinoma would have negative for GATA3, p63 but positive for PAX8.

References: https://tumourclassification.iarc.who.int/chaptercontent/36/90

Case credit: UCSD Pathology

Author: Wangpan Shi, MD