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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-. In a cirrhotic liver, a clear cell tumor is more likely to be HCC than metastatic RCC.