| Acinic cell carcinoma
of the lung (“Fechner tumor”): a clinicopathologic,
immunohistochemical and ultrastructural study of five cases. Am J Surg
Pathol 1992;16:1039–1050.
The clinical, pathological,
immunohistochemical, and ultrastructural features in five cases of
primary acinic cell carcinoma of the lung are presented. The patients'
ages ranged from 44 to 75 years (mean, 56); four were women and one a
man. The lesions were discovered incidentally on routine chest x-ray
and ranged from 1.2 to 4 cm in greatest diameter. Three tumors were
located in the right middle lobe, one in the right upper lobe, and one
in the left upper lobe. In three cases, the lesions presented as
asymptomatic subpleural nodules in proximity to secondary bronchi, one
case presented as an endobronchial tumor that led to obstructive
symptoms, and one case as a well-circumscribed deep parenchymal
nodule. Histologically, the tumors were composed of clear cells with
abundant granular cytoplasm growing as solid sheets with focal acinar,
microcystic, and papillocystic areas. Immunohistochemical stains
showed strong positivity of the tumor cells for low-molecular-weight
cytokeratins and epithelial membrane antigen (EMA). Focal weak
cytoplasmic positivity was observed in three cases with
alpha-1-antichymotrypsin and in one case with amylase. Stains for
vimentin, S-100 protein, chromogranin, and lysozyme were negative in
all cases examined. Electron microscopy performed in four cases showed
abundant zymogen-type cytoplasmic granules of variable electron
density characteristic of acinar-type secretory cells. All patients
were treated by lobectomy alone. Follow-up of 3 to 10 years in four
cases revealed that all patients were alive and well, with no evidence
of recurrence or metastases. Because of their relatively indolent
behavior and favorable prognosis, primary acinic cell carcinoma of the
lung must be distinguished from other primary and metastatic clear
cell tumors of the lung.
Acinic cell carcinoma:
an unusual cause of bronchial obstruction in a child.
Pediatr Dev Pathol. 2004 Sep-Oct;7(5):521-6.
Primary acinic
cell carcinomas of the lung are rare tumors, usually presenting in
adulthood as parenchymal or endobronchial masses. These lesions are
generally recognized by their morphological pattern and the presence
of periodic acid-Schiff (PAS)-positive, diastase-resistant cytoplasmic
granules. We describe a case of primary acinic cell carcinoma of the
bronchus in a 4-year-old girl. The tumor has the typical acinar
structures:weakly PAS-positive, diastase-resistant cytoplasmic
granules and intra-acinar laminated calcific structures. A lobectomy
was done with a clear bronchial resection margin. The child is well
with no evidence of recurrence or metastasis 2 years postresection.
Fine-needle aspiration
cytology of bronchial acinic cell carcinoma: a case report. Diagn
Cytopathol 2004;30:359–361.
Salivary
gland-type carcinomas of the lung are rare but well-known tumors.
Among them, acinic cell carcinoma (ACC) is extremely rare and its
cytological features have not been reported. We present a case of
bronchial ACC and describe its cytological characteristics. The tumor
occurred in a 58-yr-old man as a 15-mm polypoid lesion at the right
middle lobar bronchus and filled its lumen. Transbronchial brush
cytology and a biopsy failed to collect tumor cells but transbronchial
fine-needle aspiration (FNA) cytology was successful. The smear
obtained was richly cellular and a large number of thick-layered or
monolayered sheet-like tumor cell clusters and dissociated tumor cells
were observed. Cribriform globular spaces were common and a lobulated
acinar structure was found focally. The tumor cells had a fine
granular large polygonal cytoplasm and rather uniform round or ovoid
nuclei. The nuclei were situated eccentrically or centrally and the
nuclear/cytoplasmic ratio was consistently low. These cytological
features were essentially similar to those of ACC of the head and neck
region. The patient underwent a lobectomy and the tumor was resected
completely. Transbronchial FNA cytology was useful for diagnosing
bronchial ACC and differentiating it from other conventional and
salivary gland type carcinomas.
Primary acinic cell
carcinoma of the lung with lymph node metastasis.
Arch Pathol Lab Med. 2003 Apr;127(4):e216-9.
We report the
case of a 30-year-old woman who presented with a subpleural mass in
the lower lobe of the right lung, which was found incidentally on a
routine chest radiograph. A wedge biopsy followed by lobectomy and
lymph node staging revealed an acinic cell carcinoma with involvement
of a hilar lymph node. The subcarinal and mediastinal lymph nodes were
free of tumor. Perineural invasion was identified at the periphery of
the tumor. There was no evidence of origin from salivary gland or
involvement of any other organ. The patient was well 12 months
postoperatively. To our knowledge, this is the second case report
featuring lymph node metastasis in an acinic cell carcinoma of the
lung and the first to demonstrate perineural invasion.
Acinic cell carcinoma
of the lung with metastasis to lymph nodes.Chest.
1999 Feb;115(2):591-5.
A 64-year-old man
presented with an asymptomatic left lower lobe mass. At bronchoscopy
there was a tumor in the superior segment. Biopsy revealed an acinic
cell carcinoma. There was no evidence of salivary gland or other site
of origin. Lobectomy and lymph node staging showed involvement of
interlobar (N1) nodes, while higher stations were benign. The patient
remains well 20 months postoperatively. This is the only instance of
primary pulmonary acinic cell carcinoma with lymph node metastasis
among 15 cases in the literature. We review the clinical features,
histology, and treatment of the reported cases.
Acinic cell carcinoma
of the trachea. Auris Nasus Larynx 1994;21:193–195.
Acinic cell
carcinoma (ACC) appears primarily in the parotid gland. It is
extremely rare in the respiratory tract and only a few cases of ACC in
the lungs, larynx, nose, and paranasal sinuses have been described. We
present here a case of ACC located in the trachea and discuss possible
therapeutic strategies in the light of this tumor behavior relating to
other sites.
Predominantly
mucous-differentiated acinic cell adenocarcinoma of the trachea.
Zentralbl Allg Pathol 1989;135:751–756.
Reported in this
paper is a predominantly mucous differentiated acinic cell
adenocarcinoma of seromucous tracheal glands in a male patient aged 64
years. Local surgical treatment was performed several times within one
year and was always followed by recurrence. The naked eye inspection
showed a partial polypous appearance of the tumor. Histologically the
carcinoma is composed of lobular arranged solid and cribrous cell
formations only separated by a sparse fibrous stroma. The tumor is not
capsulated, and invasive growth is evident. Large cells with abundant
bright cytoplasm and a strongly positive reaction to PAS form the main
constituent of the tumor. Signet cell formation sometimes occurs.
Electron microscopic examination reveals abundant secretory granules.
These cells are in full accordance with mucous cellular elements of
adjacent seromucous tracheal glands from which this rare tumor has
obviously originated.
Acinic cell carcinoma
of the trachea: a case report. Gan No Rinsho 1984;30:1412–1416.
A 27-year-old
woman was admitted to our hospital complaining of dyspnea.
Bronchoscopic examination revealed an endotracheal mass in the lower
trachea. Endoscopic removal of the lesion was done by the
electrocoagulation method followed by wide circumferential excision
and reconstruction of the trachea three days later. The patient made
an uneventful recovery and has had no recurrence in two years of
follow-up. The diagnosis of acinic cell carcinoma was made by light
microscopy. This is the first description, to our knowledge, of a
primary neoplasma of the intrathoracic trachea having the histological
appearance of a salivary gland acinic cell tumor.
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Histologically, the tumours
are composed of clear cells with
abundant granular cytoplasm growing as solid sheets with focal acinar,
microcystic, and papillocystic areas.