Advertisement
Advertisement
Table of Contents
Definition / general | Epidemiology | Clinical features | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Electron microscopy description | Electron microscopy images | Differential diagnosisCite this page: Acinic cell carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/breastmalignantaciniccellcarcinoma.html. Accessed July 14th, 2017.
Definition / general
- Identical to salivary gland counterpart, has serous differentiation
- These carcinomas show diffuse infiltrative growth patterns of small glandular structures and are composed of cells with a coarse granular or clear cytoplasm resembling acinar cells of the salivary glands or Paneth cells
- See also Salivary Glands chapter
- Although similar in some respects to secretory carcinoma (Histopathology 2002;40:223), it lacks its characteristic ETV6 gene rearrangement (Histopathology 2008;52:840)
Epidemiology
- Uncommon in breast, < 20 cases reported
Clinical features
- In salivary glands, may undergo high grade transformation (Am J Surg Pathol 2009;33:1137)
- In parotid gland, poorer prognosis if high mitotic activity and necrosis (Cancer 2009;115:2128)
- Clinically low grade malignant tumor even if unfavorable prognostic parameters such as high mitotic activity and steroid hormone receptor negativity (Histopathology 2004;45:645)
Case reports
- 39 year old woman (J Breast Cancer 2011;14:160)
- 42 year old woman (Virchows Arch 1996;429:69)
- 49 year old woman with death due to disease (J Clin Pathol 2002;55:545)
- Japanese woman (Pathol Int 2007;57:43)
Gross description
- Often well circumscribed but may be infiltrative
- Gray pink and hemorrhagic cut surface
- 2 - 5 cm
Gross images
Images hosted on other servers:
5.5 cm ill defined mass
Microscopic (histologic) description
- Monotonous proliferation of cells with abundant finely granular, weakly eosinophilic or clear vacuolated cytoplasm, central round nuclei and prominent nucleoli, resembling acinic cells of salivary gland (J Clin Pathol 2003;56:497)
- Cytoplasmic dark eosinophilic coarse granules (resembling Paneth cells) can be seen
- Often clear cells
- May have microglandular pattern (Virchows Arch 2000;437:74)
- Up to 15 mitotic figures / 10 HPF
- May be mixed with ductal carcinoma-like cells (Am Surg 2002;68:993)
Microscopic (histologic) images
Images hosted on other servers:
Post chemo tumor
has cells with
clear vacuolated
cytoplasm
Salivary gland tumors:
Microcystic and
solid patterns in
tumors from father
and daughter
Various images
Tumor cells have prominent cytoplasmic granularity
has cells with
clear vacuolated
cytoplasm
Fig A / B
Salivary gland tumors:
Papillary fronds with hobnail cells and vacuolated cells
solid patterns in
tumors from father
and daughter
Tumor with clear cells
Dedifferentiated tumor
Various images
Fig 1: Dedifferentiated parotid tumor with some classic areas
Fig 2: Mitotic figures and necrosis
Fig 3: Differentiated areas with basophilic cytoplasm and vesicular nuclei
Fig 4: PAS+ diastase resistant granules
Positive stains
- CK7 (may be focal or weak), amylase
- Granules are PAS+ diastase resistant
- E-cadherin
- Also lysozyme, EMA, myoepithelial markers (including S100), alpha-1-antitrypsin
Electron microscopy description
- Multiple round, electron dense, cytoplasmic secretory granules
Electron microscopy images
Images hosted on other servers:
Clear cells in post
chemo patient
have dilated endo-
plasmic reticulum
Electron dense granules
chemo patient
have dilated endo-
plasmic reticulum
Variably sized electron dense granules in the cytoplasm
Differential diagnosis
- Lactating lobule: lysozyme+, benign morphology
- Microglandular adenosis: intact basal lamina
Advertisement
