Adenoma with clear cell change of the large intestine

J Surg Oncol. 1998 Mar;67(3):182-5. doi: 10.1002/(sici)1096-9098(199803)67:3<182::aid-jso7>;2-5.


Background and objectives: Clear cell change of the large intestinal neoplasm is rare, and its character remains unclear. We report a case of the large intestinal adenoma with clear cell change with immunohistochemical and molecular studies to investigate whether the clear cell change is associated with a malignant progression of the adenoma.

Methods: We studied the histochemical and immunohistochemical staining characteristics of the tumor by staining with hematoxylin-eosin, periodic acid-Schiff, alcian blue, and by immunostaining using antibodies against carcinoembryonic antigen, epithelial membrane antigen, p53, and Ki-67. The c-K-ras codon 12 point mutations were analyzed using a nonradioactive restriction fragment length polymorphism technique.

Results: The tumor was composed of a typical tubular adenoma and a tubular adenoma with clear cytoplasm. The clear cytoplasm was negative by mucin stains. Immunohistochemically p53 was negative in both the components. Labeling index of Ki-67 showed no significant difference between the two components. No codon 12 mutation of c-K-ras gene was observed in both the components.

Conclusion: These findings suggest that the clear cell change of the tubular adenoma is not associated with a malignant progression in adenoma-carcinoma sequence involving c-K-ras and p53.

Publication types

  • Case Reports

MeSH terms

  • Adenoma / genetics
  • Adenoma / pathology*
  • Carcinoembryonic Antigen / analysis
  • Colonic Neoplasms / genetics
  • Colonic Neoplasms / pathology*
  • Genes, p53
  • Genes, ras / genetics
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen / analysis
  • Male
  • Middle Aged
  • Mutation
  • Polymerase Chain Reaction
  • Polymorphism, Restriction Fragment Length


  • Carcinoembryonic Antigen
  • Ki-67 Antigen