Acinar cell tumors
Acinar cell cystadenocarcinoma

Topic Completed: 1 August 2012

Minor changes: 6 March 2020

Copyright: 2002-2020,, Inc.

PubMed Search: Acinar cell cystadenocarcinoma pancreas

Deepali Jain, M.D.
Page views in 2019: 880
Page views in 2020 to date: 668
Cite this page: Jain D. Acinar cell cystadenocarcinoma. website. Accessed August 12th, 2020.
Definition / general
  • Typically large tumors up to 17 cm containing multiple cysts
  • Marked atypia, frequent mitotic activity
Gross description
  • Large multilocular cystic mass with a pseudocapsule and a spongy appearance
Gross images


7 kg, multiloculated cystic neoplasm of pancreatic tail / body; thick fibrous capsule surrounds mass, cysts contain serous watery fluid, vary from pinpoint to 7 cm; cysts are lined by smooth, white glistening surface; no gross pancreatic tissue is present; tumor attached to but did not invade spleen (upper right)

Microscopic (histologic) description
  • Cysts are lined by a single layer of cuboid / columnar cells
  • Cytoplasm has characteristics of acinar cells, with eosinophilic granules in the apex and prominent nucleoli (Hum Pathol 2004;35:1568)
Microscopic (histologic) images


Numerous variably sized microcysts

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Numerous variably sized microcysts

Differential diagnosis
  • Acinar cell cystadenoma: no malignant features, no invasion
  • Acinar cell hyperplasia: common, resembles islets, may have minor atypia, may be premalignant
  • Pancreatic endocrine neoplasm: rare mitoses, no polarization, indistinct nucleoli, amyloid stroma, trabeculae, stippled chromatin, although acinar cell may contain scattered endocrine cells and mixed tumors are common
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