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Pancreas

Tumors

Acinar cell cystadenoma


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

General
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● Either clinically recognized macroscopic or incidental microscopic (WHO)
● First described in 2002 (Am J Surg Pathol 2002;26:698)
● Rare benign cystic neoplasm of the pancreas (Pancreas 2008;37:254, Am J Surg Pathol 2012;36:1579)
● 70% women, ages 16 to 66 years
● Benign behavior

Case reports
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● 24 year old woman with 6 cm cystic lesion in the head of the pancreas (Case of the Week #136)
● 52 year old man with incidental tumor (Am J Clin Pathol 2002;118:211)

Treatment
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● Excision

Gross description
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● Mean 6 cm, unilocular or multilocular cysts with watery fluid, cysts usually not connected with ductal system

Gross images
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Various images

Micro description
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● Well circumscribed, mature acinar cells with abundant eosinophilic granular cytoplasm and round, basal nuclei
● Cyst lined by flattened cells resembling normal ductal epithelium, but with focal acinar cells and admixed with dilated acini
● May be adjacent to mucinous ductal epithelium
● Eosinophilic secretions form oval plugs
● No papillary projections or solid areas, no ovarian type stroma, no PanIN lesions
● No atypia, no mitotic activity, no vascular invasion, no relationship to major ductal system (Stanford University)

Micro images
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Case of the week #136: H&E and trypsin


Various images

Positive stains
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● PAS, lipase, trypsin, chymotrypsin, CK7

Negative stains
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● Ki-67

Electron microscopy images
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Case of the week 136

Differential diagnosis
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Acinar cell cystadenocarcinoma: more complex epithelium, nuclear atypia, prominent nucleoli; often necrosis, solid nests of tumor cells, mitotic figures, infiltration into surrounding stroma)
PanIN: no acinar cells, variable atypia

End of Pancreas > Tumors > Acinar cell cystadenoma


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