Difference between revisions of "Acinic cell carcinoma"

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Acinic cell carcinoma (view source)

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| LMDDx      = [[oncocytoma of the salivary gland]], [[mucoepidermoid carcinoma]], adenocarcinoma NOS, [[secretory carcinoma of the salivary gland]]
| LMDDx      = [[oncocytoma of the salivary gland]], [[mucoepidermoid carcinoma]], adenocarcinoma NOS, [[secretory carcinoma of the salivary gland]]
| Stains    = PAS +ve, PASD +ve
| Stains    = PAS +ve, PASD +ve
| IHC        = p63 -ve, S-100 -ve
| IHC        = p63 -ve, S-100 -ve, CK7 +ve, CK19 +ve, NR4A3 +ve, alpha1-ACT +ve
| EM        = [[zymogen granules]]
| EM        = [[zymogen granules]]
| Molecular  =
| Molecular  = t(4;9)(q13;q31)
| IF        =
| IF        =
| Gross      = tan or reddish
| Gross      = tan or reddish
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*Nuclear atypia.
*Nuclear atypia.
*[[Perineural invasion]].
*[[Perineural invasion]].
*[[Mitoses]].
*Mitoses.
*Infiltrative margin.
*Infiltrative margin.
*Tumour sclerosis.
*Tumour sclerosis.
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==IHC==
==IHC==
*CK7 +ve.<ref name=pmid26166029>{{cite journal |authors=Li X, Shi Z, Wang Y, Liu Y, Liu T |title=Immunohistochemical expression of cytokeratins in human salivary gland acinic cell carcinomas |journal=Oral Surg Oral Med Oral Pathol Oral Radiol |volume=120 |issue=2 |pages=248–57 |date=August 2015 |pmid=26166029 |doi=10.1016/j.oooo.2015.04.014 |url=}}</ref>
*CK19 +ve.<ref name=pmid26166029/>
*NR4A3 +ve (nuclear) (5 of 6 cases<ref name=pmid33959239>{{cite journal |authors=Owosho A, Tyler D, Adesina O, Odujoko O, Summersgill K |title=NR4A3 (NOR-1) Immunostaining Shows Better Performance than DOG1 Immunostaining in Acinic Cell Carcinoma of Salivary Gland: a Preliminary Study |journal=J Oral Maxillofac Res |volume=12 |issue=1 |pages=e4 |date=2021 |pmid=33959239 |pmc=8085676 |doi=10.5037/jomr.2021.12104 |url=}}</ref>; 18 of 20 cell blocks<ref name=pmid26166029>{{cite journal |authors=Li X, Shi Z, Wang Y, Liu Y, Liu T |title=Immunohistochemical expression of cytokeratins in human salivary gland acinic cell carcinomas |journal=Oral Surg Oral Med Oral Pathol Oral Radiol |volume=120 |issue=2 |pages=248–57 |date=August 2015 |pmid=26166029 |doi=10.1016/j.oooo.2015.04.014 |url=}}</ref>; 9 of 9 surgicals<ref name=pmid26166029/>).
*Alpha1-ACT (also ''AACT'') +ve.
Negative:
*S-100 -ve.
*S-100 -ve.
*p63 -ve (30 -ve of 30 cases<ref name=pmid23054955/>).
*p63 -ve (30 -ve of 30 cases<ref name=pmid23054955/>).
**p63 +ve in [[mucoepidermoid carcinoma]] (24 +ve of 24 cases).<ref name=pmid23054955>{{Cite journal  | last1 = Sams | first1 = RN. | last2 = Gnepp | first2 = DR. | title = P63 expression can be used in differential diagnosis of salivary gland acinic cell and mucoepidermoid carcinomas. | journal = Head Neck Pathol | volume = 7 | issue = 1 | pages = 64-8 | month = Mar | year = 2013 | doi = 10.1007/s12105-012-0403-2 | PMID = 23054955 }}</ref>
**p63 +ve in [[mucoepidermoid carcinoma]] (24 +ve of 24 cases<ref name=pmid23054955>{{Cite journal  | last1 = Sams | first1 = RN. | last2 = Gnepp | first2 = DR. | title = P63 expression can be used in differential diagnosis of salivary gland acinic cell and mucoepidermoid carcinomas. | journal = Head Neck Pathol | volume = 7 | issue = 1 | pages = 64-8 | month = Mar | year = 2013 | doi = 10.1007/s12105-012-0403-2 | PMID = 23054955 }}</ref>).


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>
A panel: CK7, CK19, AACT, mammaglobin, S-100, GATA3.
 
==Molecular==
*t(4;9)(q13;q31).<ref name=pmid33959239>{{cite journal |authors=Owosho A, Tyler D, Adesina O, Odujoko O, Summersgill K |title=NR4A3 (NOR-1) Immunostaining Shows Better Performance than DOG1 Immunostaining in Acinic Cell Carcinoma of Salivary Gland: a Preliminary Study |journal=J Oral Maxillofac Res |volume=12 |issue=1 |pages=e4 |date=2021 |pmid=33959239 |pmc=8085676 |doi=10.5037/jomr.2021.12104 |url=}}</ref>
**''Secretory Ca-binding phosphoprotein'' (SCPP) at 4q13.<ref name=pmid30664630>{{cite journal |authors=Haller F, Bieg M, Will R, Körner C, Weichenhan D, Bott A, Ishaque N, Lutsik P, Moskalev EA, Mueller SK, Bähr M, Woerner A, Kaiser B, Scherl C, Haderlein M, Kleinheinz K, Fietkau R, Iro H, Eils R, Hartmann A, Plass C, Wiemann S, Agaimy A |title=Enhancer hijacking activates oncogenic transcription factor NR4A3 in acinic cell carcinomas of the salivary glands |journal=Nat Commun |volume=10 |issue=1 |pages=368 |date=January 2019 |pmid=30664630 |pmc=6341107 |doi=10.1038/s41467-018-08069-x |url=}}</ref>
**''Nuclear Receptor Subfamily 4 Group A Member 3'' (NR4A3) at 9q31.<ref name=pmid30664630/>


==EM==
==EM==
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Comment:
Comment:
Immunostains are in keeping with acinic cell carcinoma (mammaglobin, S-100 and p63 are all NEGATIVE). A PAS stain is positive in the tumour.
The tumour stains as follows:
POSITIVE: CK7, CK19, AACT, PAS.
NEGATIVE: mammaglobin, S-100, p63.
 
The staining is in keeping with acinic cell carcinoma.
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Michael
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