Difference between revisions of "Acinic cell carcinoma"
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'''Acinic cell carcinoma''', abbreviated '''AcCC''', is a rare type of [[salivary gland]] cancer. It is also known as '''acinic cell adenocarcinoma'''. | |||
It should '''not''' to be confused with ''[[pancreatic acinar cell carcinoma]]''. | |||
==General== | |||
*Malignant neoplasm of salivary gland arising from acinic cells. | |||
*The relative prevalence of the neoplasm in the various salivary gland reflects the abundance of acinic cells: parotid gland (~80%) > minor salivary glands (~17%) > submandibular glands (~3%). | |||
*Affects wide age range -- including children. | |||
*Site affect prognosis (most aggressive to least aggressive): submandibular > parotid > minor salivary. | |||
==Gross== | |||
*Tan or reddish. | |||
==Microscopic== | |||
Features: | |||
*Sheets of acinic cells with: | |||
**Abundant finely vacuolated cytoplasm with basophilic granules - '''key feature'''. | |||
***Granules may be focal. | |||
**Small nuclei stippled chromatin. | |||
*Scattered intercalcated duct type cells with: | |||
**Eosinophilic cytoplasm with moderate amount of cytoplasm. | |||
**Bland nuclei with slightly larger than seen in acinic cells. | |||
*+/-Peri-tumoural lymphocytes. | |||
*+/-Glassy extracellular bluish/purple blobs. | |||
Notes: | |||
*Adipose tissue -- present in the salivary glands -- is absent in AcCC. | |||
*May focally resemble thyroid tissue. | |||
*Smaller (characteristic) microvacuoles (unreported in the literature) may be present that have a bubbly appearance and glassy basophilic inclusions.<ref name=IW_10jan2011>IW. 11 January 2011.</ref> | |||
Memory device: | |||
*AcCC - lots of "C"s - '''c'''hromatin stipled, '''c'''ytoplasm generous. | |||
DDx: | |||
*[[Oncocytoma of the salivary gland]]. | |||
*Adenocarcinoma not otherwise specified.<ref name=pmid12608654>{{Cite journal | last1 = Ihrler | first1 = S. | last2 = Blasenbreu-Vogt | first2 = S. | last3 = Sendelhofert | first3 = A. | last4 = Lang | first4 = S. | last5 = Zietz | first5 = C. | last6 = Löhrs | first6 = U. | title = Differential diagnosis of salivary acinic cell carcinoma and adenocarcinoma (NOS). A comparison of (immuno-)histochemical markers. | journal = Pathol Res Pract | volume = 198 | issue = 12 | pages = 777-83 | month = | year = 2002 | doi = | PMID = 12608654 }}</ref> | |||
===Images=== | |||
<gallery> | |||
Image:Acinic_cell_carcinoma_-_intermed_mag.jpg | AcCC - intermed. mag. (WC/Nephron) | |||
Image:Acinic_cell_carcinoma_-_high_mag.jpg | AcCC - high mag. (WC/Nephron) | |||
Image:Acinic_cell_carcinoma_-_very_high_mag.jpg | AcCC - very high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=20080802170246445 AcCC (surgicalpathologyatlas.com)]. | |||
*[http://www.brown.edu/Courses/Digital_Path/systemic_path/hn/acinic.html AcCC (brown.edu)]. | |||
*[http://www.aciniccell.org/acc_images14.html AcCC (aciniccell.org)] - image collection. | |||
===Grading=== | |||
General: | |||
*Not prognostic. | |||
*Done to avoid phone calls from clinician. | |||
Factors Weinreb uses:<ref name=IW_10jan2011>IW. 11 January 2011.</ref> | |||
*[[Necrosis]]. | |||
*Nuclear atypia. | |||
*[[Perineural invasion]]. | |||
*[[Mitoses]]. | |||
*Infiltrative margin. | |||
*Tumour sclerosis. | |||
===Subtypes=== | |||
*Oncocytic variant - rare. | |||
*Clear cell variant - rare. | |||
*Papillary cystic variant. | |||
==Stains== | |||
*PAS +ve. | |||
*PAS-D +ve. | |||
==IHC== | |||
*S-100 -ve. | |||
*p63 -ve. | |||
**p63 +ve in mucoepidermoid carcinoma. | |||
There are a bunch of other [[stains]] that are touted to be useful (amylase, anti-chymotrypsin, lactoferrin). Weinreb thinks these are '''not''' helpful.<ref name=IW_10jan2011>IW. 11 January 2011.</ref> | |||
==EM== | |||
*[[Zymogen granules]].<ref name=pmid14991547>{{Cite journal | last1 = Sun | first1 = Y. | last2 = Wasserman | first2 = PG. | title = Acinar cell carcinoma arising in the stomach: a case report with literature review. | journal = Hum Pathol | volume = 35 | issue = 2 | pages = 263-5 | month = Feb | year = 2004 | doi = | PMID = 14991547 }}</ref> | |||
==See also== | |||
*[[Salivary glands]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Salivary gland]] | |||
[[Category:Head and neck pathology]] | |||
Revision as of 22:05, 29 July 2013
Acinic cell carcinoma, abbreviated AcCC, is a rare type of salivary gland cancer. It is also known as acinic cell adenocarcinoma.
It should not to be confused with pancreatic acinar cell carcinoma.
General
- Malignant neoplasm of salivary gland arising from acinic cells.
- The relative prevalence of the neoplasm in the various salivary gland reflects the abundance of acinic cells: parotid gland (~80%) > minor salivary glands (~17%) > submandibular glands (~3%).
- Affects wide age range -- including children.
- Site affect prognosis (most aggressive to least aggressive): submandibular > parotid > minor salivary.
Gross
- Tan or reddish.
Microscopic
Features:
- Sheets of acinic cells with:
- Abundant finely vacuolated cytoplasm with basophilic granules - key feature.
- Granules may be focal.
- Small nuclei stippled chromatin.
- Abundant finely vacuolated cytoplasm with basophilic granules - key feature.
- Scattered intercalcated duct type cells with:
- Eosinophilic cytoplasm with moderate amount of cytoplasm.
- Bland nuclei with slightly larger than seen in acinic cells.
- +/-Peri-tumoural lymphocytes.
- +/-Glassy extracellular bluish/purple blobs.
Notes:
- Adipose tissue -- present in the salivary glands -- is absent in AcCC.
- May focally resemble thyroid tissue.
- Smaller (characteristic) microvacuoles (unreported in the literature) may be present that have a bubbly appearance and glassy basophilic inclusions.[1]
Memory device:
- AcCC - lots of "C"s - chromatin stipled, cytoplasm generous.
DDx:
- Oncocytoma of the salivary gland.
- Adenocarcinoma not otherwise specified.[2]
Images
AcCC - intermed. mag. (WC/Nephron)
AcCC - high mag. (WC/Nephron)
AcCC - very high mag. (WC/Nephron)
www:
- AcCC (surgicalpathologyatlas.com).
- AcCC (brown.edu).
- AcCC (aciniccell.org) - image collection.
Grading
General:
- Not prognostic.
- Done to avoid phone calls from clinician.
Factors Weinreb uses:[1]
- Necrosis.
- Nuclear atypia.
- Perineural invasion.
- Mitoses.
- Infiltrative margin.
- Tumour sclerosis.
Subtypes
- Oncocytic variant - rare.
- Clear cell variant - rare.
- Papillary cystic variant.
Stains
- PAS +ve.
- PAS-D +ve.
IHC
- S-100 -ve.
- p63 -ve.
- p63 +ve in mucoepidermoid carcinoma.
There are a bunch of other stains that are touted to be useful (amylase, anti-chymotrypsin, lactoferrin). Weinreb thinks these are not helpful.[1]
EM
See also
References
- ↑ 1.0 1.1 1.2 IW. 11 January 2011.
- ↑ Ihrler, S.; Blasenbreu-Vogt, S.; Sendelhofert, A.; Lang, S.; Zietz, C.; Löhrs, U. (2002). "Differential diagnosis of salivary acinic cell carcinoma and adenocarcinoma (NOS). A comparison of (immuno-)histochemical markers.". Pathol Res Pract 198 (12): 777-83. PMID 12608654.
- ↑ Sun, Y.; Wasserman, PG. (Feb 2004). "Acinar cell carcinoma arising in the stomach: a case report with literature review.". Hum Pathol 35 (2): 263-5. PMID 14991547.