Cases Of Acinic Cell Carcinoma Research Articles

Acinic Cell Carcinoma of the Trachea

Acinic cell carcinoma (ACC) appears primarily in the parotid gland. It is extremely rare in the respiratory tract and only a few cases of ACC in the lungs, larynx, nose, and paranasal sinuses have been described. We present here a case of ACC located in the trachea and discuss possible therapeutic strategies in the light of this tumor behavior relating to other sites.

Acinar cell carcinoma of the pancreas. A clinicopathologic study of 28 cases.

We have examined the microscopic appearance, immunohistochemical staining properties, and clinical behavior of 28 cases of acinar cell carcinoma of the pancreas. Two of the tumors occurred in children. The adult patients ranged in age from 40 to 81 years (mean, 62 years). Males greatly outnumbered females, and most of the patients were white. Presenting symptoms were nonspecific, and jaundice was infrequent. The frequently reported complications from increased serum lipase levels (i.e., arthralgias and subcutaneous fat necrosis) were present in only 16% of the patients. Grossly, the tumors were relatively circumscribed and fleshy, averaging 10.8 cm, with occasionally extensive hemorrhage and necrosis. Microscopically, the tumors were very cellular and characteristically lacked a desmoplastic stroma. Acinar, solid, trabecular, and glandular patterns of growth were identified; individual tumors were usually mixed. Nuclei were round to oval, with minimal pleomorphism and single prominent nucleoli. Mitotic activity was variable. In general the cytoplasm was moderately abundant, eosinophilic, and granular, but many of the solid tumors had cells with scanty cytoplasm. Characteristic periodic acid-Schiff-positive, diastase-resistant cytoplasmic granules were demonstrated in greater than 90% of the cases, and the butyrate esterase histochemical stain for lipase activity was positive in 73%. Immunohistochemically, there was positivity for trypsin in 100% of the cases, for lipase in 77%, for chymotrypsin in 38%, and for amylase in 31%. A minor endocrine component was recognized with antibodies against chromogranin or islet cell hormones in 42% of the tumors. Ultrastructurally, exocrine secretory features were present, with polarized cells showing microvillilined lumina, abundant rough endoplasmic reticulum, and 125-1,000-nm zymogen-like granules. In addition, many cases showed pleomorphic electron-dense granules measuring up to 3,500 nm and containing fibrillary internal structures. Follow-up information was available in 88% of the cases. Half of the patients had metastatic disease at presentation and an additional 23% subsequently developed metastases, which were usually restricted to the regional lymph nodes and liver. The mean survival for all cases was 18 months, with 1- and 3-year survivals of 57 and 26%, respectively. Patients presenting before age 60 years survived nearly twice as long as older patients did. Stage also influenced prognosis, whereas the histologic subtype of the tumors and the location within the pancreas correlated only weakly with survival.

Distribution of Tissue Markers in Acinic Cell Carcinomas of Salivary Gland

Eight cases of acinic cell carcinoma of the salivary glands were histologically reclassified and their immunohistochemical expression and distribution for various tissue antigens were examined. The epithelial elements were divided into tubuloglandular components, microcystic patterns and solid nests. The authors' results indicated the following: 1) The duct luminal cells of tubuloglandular components have distinct epithelial features with cytokeratin (KL 1), alpha 1-antichymotrypsin (alpha 1-ACT), transferrin, lactoferrin, IgA, and carcinoembryonic antigen (CEA) positivity. 2) The cyst-lining cells of microcystic pattern expressed immunophenotypes similar to those of the duct luminal cells. 3) The acinic cells in solid nests had positive results for KL 1, alpha 1-antitrypsin (alpha 1-AT), transferrin, lactoferrin and vasoactive intestinal polypeptide (VIP). 4) The clear cells in solid areas had positive results for KL 1, alpha 1-AT, transferrin and VIP. Both the clear cells and the neoplastic acinic cells showed a rather similar pattern of immunoreactivity. Therefore, the clear cells may transform from the neoplastic acinic cells. 5) Secretory products in tubuloglandular and microcystic patterns had positive results for alpha 1-ACT, lactoferrin, IgA and CEA. 6) The basement membrane-like material between the neoplastic islands has distinct positivity for alpha 1-AT. The result suggests that alpha 1-AT is a useful marker of basement membrane-like material.

Acinic cell carcinoma. Clinicopathologic review

The authors reviewed 90 cases of acinic cell carcinoma treated at the Mayo Clinic to assess long-term follow-up and to study features predictive of disease progression. Sixty-three patients (55 females and 35 males) were seen for primary treatment; 27 had recurrent disease when first evaluated. Histologically, these tumors were composed of serous acinar cells and intercalated duct-type cells. Morphologic patterns included solid, microcystic, follicular, and papillary-cystic. All patients were followed for at least 10 years or until death. Of the primary treatment group, 44% had local recurrence, 19% had metastasis, and 25% died of disease. Disease first recurred locally up to 30 years after presentation and resulted in death after as many as 38 years. Poor prognostic features include pain or fixation; gross invasion; microscopic features of desmoplasia, atypia, or increased mitotic activity; and excision as initial treatment. Neither morphologic pattern nor cell composition was a predictive feature.

Acinar cell carcinoma of the pancreas ultrasonography and computed tomography findings

The radiologic findings in two cases of acinar cell carcinoma of the pancreas are described. Sonographic findings were a midrange echogenic mass with heterogeneity, containing some small- and medium-sized low echogenic areas suggesting necrosis. Ultrasonic through-transmission was good. Computed tomography findings were a well-defined, hypodense, large mass having an enhancing, thin capsule. There were multiple small- and medium-sized irregular low-density areas suggesting necrosis. Small punctate calcific foci were present in one case. With these characteristics, acinar cell carcinoma can be distinguished from the locally invasive common adenocarcinoma of the pancreas, but the differentiation from some other less common pancreatic tumors remains difficult.

Acinic cell carcinoma of salivary glands: 16 cases with clinicopathologic correlation.

Sixteen cases of acinic cell carcinoma (ACC) of salivary glands were studied and their different clinicopathologic aspects were analysed. ACC occurred more frequently in the 5th and 6th decades of life, and was seen exclusively in major salivary glands. The main complaint of the patients was the presence of a mass, and the majority of the tumors were Stage III and IV when first seen in our institution. The tumors were divided into three histologic grades based on cellular pleomorphism, mitotic activity, and necrosis. This study showed correlation between prognosis and grading. Other important factors in the prognosis were the type of treatment and the duration of symptoms. Surgical resection with free margins is the treatment of choice.

多発早期胃癌に併存した肝転移を有する微小すい腺房細胞癌の１切除例

多発早期胃癌に併存した肝転移を有する微小すい腺房細胞癌の１切除例

Atypical and neoplastic acinar cell lesions of the pancreas in an autopsy study of Japanese patients.

A histopathologic examination of the pancreas was performed on a series of adult Japanese autopsies. In ten of 162 pancreases (6%) with adequate tissue available, two types of focal atypical acinar cell lesions, composed of acidophilic or basophilic cells, were found. Acidophilic atypical acinar cell lesions were more frequent than basophilic ones, although the one case of acinar cell adenoma and two cases of acinar cell carcinomas showed high incidences of basophilic atypical acinar cell lesions. The findings are concluded to support the possibility that atypical acinar cell lesions are precursors for acinar cell carcinomas.

Acinic cell carcinoma arising in the glossopalatine glands: A report of two cases with electron microscopic observations

Two cases of acinic cell carcinoma arising in the glossopalatine glands were examined with the electron microscope by means of conventional thin sectioning and freeze-fracturing. Light and electron microscopic observation revealed that the tumors consisted of three types of cells: serous-type, ductlike, and vacuolated cells. Serous-type cells had numerous secretory granules, some of which were discharged into the intercellular spaces. Ductlike cells were smaller, usually lacked secretory granules, and were similar to intercalated duct cells. Vacuolated cells had electron-opaque vacuoles in the cytoplasm. Our findings supported the hypothesis that acinic cell carcinoma may represent a neoplasm of multipotential duct cells which have differentiated mainly into granulated serous cells. Freeze-fracture images of this tumor revealed that tight junctions were composed of ten or more interlinked strands with elongation of basal frontier strands. These findings suggested that the junctional morphology of the tumor resembled that of developing salivary glands and was associated with the degree of cellular differentiation.

Acinic cell carcinoma of minor salivary glands.

Three cases of acinic cell carcinoma of minor salivary glands, located respectively in the larynx, base of the tongue, and right tonsil, were encountered at the Section of Pathology of the ENT Department of the University of Padua between 1974 and 1978. Such neoplasms arising in minor salivary gland tissue are extremely rare, but may be found in all sites containing normal or aberrant salivary gland tissue. The histological and histochemical characteristics of the tumour are discussed together with the differential diagnosis from other neoplasms, particularly clear-celled tumours such as glycogen rich adenocarcinoma, mucoepidermoid carcinoma, metastatic clear cell renal adenocarcinoma and clear cell squamous carcinoma. In general, acinic cell carcinoma can be defined as a tumour of low-grade malignancy, though not too rarely it may recur and occasionally metastasize.

Acinic cell carcinomas arising in salivary glands: a clinicopathologic study.

Fifty-one cases of acinic cell carcinoma (ACC) arising in major and minor salivary glands are reported (primary sites: parotid 37, submandibular, six, and oral cavity, eight.) These lesions usually produced painless slowly growing masses. Of 49 patients with follow-up information, 17 (35%) developed local recurrences following original surgical resection, and two (4%) had locally persistent disease. At last follow-up, 27 patients (55%) never had a recurrence, seven (14%) had experienced local recurrences but the tumors were apparently controlled by further surgical excisions, five (10%) were living with persistent disease, and 10 (20%) had died (one due to local tumor and nine due to metastases, usually to bones and lungs). The determinate 5-, 10- and 15-year survival rates were 78%, 63%, and 44%, respectively. Prognostic factors included: demonstrable tumor on lines of surgical excision, involvement of deep lobe of parotid, size of primary lesion, degree of mitotic activity and nuclear atypia, infiltrative rather than circumscribed borders, and lymph node involvement. Local recurrence was associated with an increased incidence of locally uncontrollable and metastatic disease. Type of initial therapy correlated with prognosis. Locally recurrent or persistent tumor was found in 14 of 15 patients treated with limited local excisions (including one biopsy only). Recurrences were seen in only three of 28 patients treated by wide local excisions and in two of six following radical en bloc resections. Seven of 17 patients with local recurrence were apparently cured by further more extensive resection. Radiotherapy did not appear effective in controlling these neoplasms.

Acinic Cell Carcinoma of the Oral Palate

The patient, a 67 year old female complained of swelling in the oral palate for the last three months, but she denied any pain in the lesion. There was no evidence of enlarged lymphnodes or metastasis. The tumor was resected and its surrounding soft tissue revealed an acinic cell carcinoma of the oral palate. Despite irradiation therapy after the first operation, (total dose 4500 rad for three weeks, ) local recurrence was noted without a sign of metastasis. A second radical operation was then performed. The resected area consisted of the original tumorous site and the surrounding healthy soft tissue of the oral palate and also included part of the bony oral palate. At the same time, the first staged plastic operation of the oral palate was done to prevent speech disturbance.The patient had a good clinical course without recurrence, metastasis or remarkable speech disturbance.According to our study, only 18 cases of acinic cell carcinoma of the minor salivary glands have been reported in the literature.

Acinar Cell Carcinoma of the Pancreas in a 9-Year-Old Child

A case of acinar cell carcinoma of the pancreas in a 9-year-old boy is presented, in which the diagnosis was established by electron microscopy. Treatment was by combination chemotherapy and the survival time was two years.

Acinic cell carcinoma of the major salivary glands

A study was made of fifty patients having acinic cell carcinoma, including forty-seven tumors of the parotid gland and three sub-maxillary tumors, treated at the Mayo Clinic from 1918 through 1961. Follow-up study in forty-six cases ranged from one to forty-one years after initial treatment. Evidence presented supports the concepts that these tumors originate in acini of the salivary gland and that they should be considered as malignant tumors. The results of treatment indicate that a more aggressive surgical approach at the time of initial therapy offers the best opportunity for cure. More than 100 cases of acinic cell carcinoma of the parotid gland have been reported in the literature.