Lung tumor - Acinar cell carcinoma

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Lung tumor

Adenocarcinoma

Acinar cell carcinoma

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 13 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Malignant glandular epithelial neoplasm consisting of secretory cells forming acinar patterns (WHO)
● Bronchial gland tumor resembling salivary gland tumor, well circumscribed, 1-5 cm, with predominantly low grade malignant acinar cells (note difference from WHO definition)
● Very rare at this site, usually in parotid gland, less commonly in submandibular and sublingual glands
● Also known as Fechner tumor
● May arise from pluripotent cells of tracheobronchial submucosal serous and mucus glands

Case reports
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● 30 year old woman with primary acinic cell carcinoma of lung with lymph node metastasis (Arch Pathol Lab Med 2003;127:e216)

Treatment
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● Surgical excision

Micro description
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● Low grade tumor with acinar, oncocytic, papillocystic patterns (Am J Surg Pathol 1992;16:1039)
● Predominantly acinar cells, also ductal cells, myoepithelial cells, reserve/stem cells
● Solid areas recapitulate salivary gland acinar differentiation with large polyhedral cells containing abundant granular cytoplasm, round bland nuclei
● Microcystic areas recapitulate terminal duct-acinar unit
● In contrast to salivary gland tumor, no/rare perineural invasion
● No nuclear pleomorphism, no mitotic activity

Micro images
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Acinic cell carcinoma: primary and recurrent tumor

Salivary gland acinic cell carcinoma: various images

Positive stains
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● Cytokeratin, EMA

Negative stains
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● Amylase

Electron microscopy description
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● No melanosomes, no abundant cytoplasmic glycogen, no neurosecretory granules, no abundant mitochondria or fat globules

Differential diagnosis
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● Clear cell (sugar) tumor of lung
● Granular cell tumor
● Oncocytic carcinoma
● Oncocytoma
● Metastatic renal cell carcinoma
● Metastastic salivary gland tumor
● Primary lung adenocarcinoma

End of Lung tumor > Adenocarcinoma > Acinar cell carcinoma

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