acinic cell carcinoma

Images

 Acinic cell carcinoma

• https://twitter.com/CaryBureshMD/status/718543701614718977
• cytology : https://twitter.com/aakasharmand/status/944305890294947845

 DOG1+

• https://twitter.com/chioseasi/status/728565595176873984

 Wikimedia: Acinic cell carcinoma

Cytology

 sheets of cells
 cytoplasm : abundant and granular
 nuclei : exxenctric
 nucleoli : small inconspicuous
 background : many naked nuclei
 images :

• https://twitter.com/Yalwelaie/status/1326545961959612416

Differential diagnosis :

 salivary oncocytic tumors
 salivary myoepithelial tumors

Evolution

High-grade transformation of acinic cell adenocarcinoma (19461506)

The median age is 61 years (with range from 43 to 76 y).

High-grade transformation of acinic cell carcinoma (AciCC) (previously referred to as dedifferentiation) is a rare phenomenon characterized by histologic progression of low-grade AciCC to high-grade adenocarcinoma or undifferentiated carcinoma.

The high-grade component is composed of polymorphic cells with a high mitotic rate arranged in glandular and solid growth patterns with comedonecrosis.

The MIB-1 labeling indices are elevated in the high-grade component, as compared with the low grade conventional AciCC.

The high-grade component of AciCC is characterized by strong membrane staining for CK18 and beta-catenin, and nuclear staining for cyclin-D1.

HER-2/neu, androgen receptor, C-kit, and epidermal growth factor receptor are absent from both low-grade and high-grade components.

In contrast, S-100 protein, alpha-1-antitrypsin, and lysozyme are lost only in high-grade foci of transformed AciCC.

Lymph node (LN) metastases are found in 56% of cases. Distant metastases to the lungs, pleura, brain, and peritoneum, and paraaortic, paratracheal, and mediastinal LNs are observed.

66% die from tumor dissemination, with a median overall survival of 4.3 years (range: 1 to 9 y).

The high propensity for LN metastases indicates the need for neck dissection at the time of diagnosis.

Localization

 mammary acinic cell carcinoma
 salivary acinic cell carcinoma
 pancreatic acinic cell carcinoma

See also

 Tumors

• Carcinomas
  • Adenocarcinomas

References

 Acinic Cell Carcinoma With High-grade Transformation: A Report of 9 Cases With Immunohistochemical Study and Analysis of TP53 and HER-2/neu Genes. Skálová A, Sima R, Vanecek T, Muller S, Korabecna M, Nemcova J, Elmberger G, Leivo I, Passador-Santos F, Walter J, Rousarova M, Jedlickova K, Curik R, Geierova M, Michal M. Am J Surg Pathol. 2009 May 20. PMID: 19461506