Salivary glands
Primary salivary gland neoplasms - malignant
Acinic cell carcinoma

Topic Completed: 1 August 2011

Minor changes: 12 March 2020

Copyright: 2002-2020,, Inc.

PubMed Search: Acinic cell carcinoma[TI] salivary[TI]

F. Zahra Aly, M.D., Ph.D.
Page views in 2019: 21,299
Page views in 2020 to date: 11,175
Cite this page: Aly FZ. Acinic cell carcinoma. website. Accessed July 5th, 2020.
Definition / general
  • 1 - 3% of all salivary gland tumors; 3% of all parotid salivary gland tumors
  • #2 childhood salivary gland malignancy after mucoepidermoid carcinoma
  • Usually parotid and minor salivary glands, also parotid lymph nodes
  • 10 - 15% metastasize (usually to local lymph nodes), 10 - 30% recur (may be due to inadequate excision)
  • 80 - 90% recur if incompletely excised
  • 5 year survival 90%, 20 year survival 60%
  • Less aggressive in minor salivary glands
Poor prognostic factors
  • High stage, pain or fixation, gross invasion, desmoplasia, anaplasia or dedifferentiated component, increased mitotic figures, necrosis, neural invasion, incomplete resection, large size, involvement of deep lobe of parotid, multinodularity
Case reports
Gross description
  • Encapsulated, tanish gray, firm to soft, solid / cystic; usually < 3 cm
  • 3% bilateral or multicentric
Microscopic (histologic) description
  • At scanning power, basophillia and prominent lymphoid infiltrate should raise suspicion of acinic cell carcinoma
  • Tumor shows multidirectional differentiation towards acinar, ductal as well as myoepithelial elements
  • Some tumor cells must demonstrate differentiation towards acinar cells
  • Variable patterns: solid, microcystic, papillary cystic (associated with hemorrhage), follicular
  • Variable cell types: uniform acinar (serous) type cells with basophilic granular cytoplasm, clear cells (hypernephroid pattern, contains glycogen or mucin), vacuolated, intercalated duct, nonspecific glandular cells (smaller, syncytial)
  • Few mitotic figures
  • May have prominent lymphoid follicles at periphery (lymphoid stroma), psammoma bodie
Microscopic (histologic) images

Case #355

Various images

Images hosted on other servers:

Papillary fronds with hobnail cells and vacuolated cells

Microcystic and
solid patterns in
tumors from
father and daughter

Figure 3A - tumor (left) and normal salivary gland (right)

Various images

1: dedifferentiated parotid tumor with some classic areas; 2: mitotic figures and necrosis; 3: differentiated areas with basophilic cytoplasm and vesicular nuclei;
4: PAS+ diastase resistant granules

Cytology images

Case #355

Various images

Positive stains
Electron microscopy description
  • Multiple round, electron flocculent material with variable granule density (dependent on fixation), cytoplasmic secretory granules
Differential diagnosis
  • Normal parotid gland: tumors lack striated and interlobular ducts, lack lobular architecture
  • Thyroid carcinoma
Back to top