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Acinar cell cystadenocarcinoma

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 25 November 2012, last major update August 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.


● 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)

Micro 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)

Micro images

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 pre-malignant
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

End of Pancreas > Tumors > Acinar cell cystadenocarcinoma

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