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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]] | |||