Acinar cell cystadenocarcinoma of human pancreas

Cantrell, Brett B.; Cubilla, Antonio L.; Erlandson, Robert A.; Fortner, Joseph; Fitzgerald, Patrick

doi:10.1002/1097-0142(19810115)47:2<410::aid-cncr2820470232>3.0.co;2-d

Cited by 88 publications

(25 citation statements)

References 11 publications

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“…An important step forward was the differentiation of serous cystic from MCNs by Compagno and Oertel [12] and Hodgkinson et al [19]. Then followed the descriptions of the cystic variants of acinar cell carcinoma [10,20,56] and the cystic (ductectatic), mucin-producing, intraductal neoplasms [47,49,52] that were finally termed intraductal papillary-mucinous tumors [21,28,39,54] and clearly distinguished from MCNs [55,63]. Recently, the IPMNs have been subdivided into an intestinal, MUC2-positive type [which appears to be the precursor of mucinous noncystic (colloid) carcinoma] [42], a pancreatobiliary, MUC1-positive type and an oncocytic type [3].…”

Section: Discussionmentioning

confidence: 99%

Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal

et al. 2004

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Although cystic neoplasms and lesions of the pancreas are rare, they have attracted a great deal of attention because of their potential curability. Since, in recent years, several new entities have been identified, the relative frequency of the tumors and their classification need to be reevaluated. In a series of 1454 tumorous lesions of the pancreas collected between 1971 and 2003 in our surgical pathology files and consultation files, all cystic pancreatic neoplasms and tumor-like lesions were identified and typed both histologically and immunohistochemically. There were 418 cases (29%) showing cysts with a diameter ranging between 0.5 cm and 27 cm. Most common were solid pseudopapillary neoplasms (21%) and intraductal papillary-mucinous neoplasms (18%). When only the cystic neoplasms and lesions that had been resected in a single institution were considered, intraductal papillary mucinous neoplasms were the most frequent cystic neoplasms, while solid pseudopapillary neoplasms took fifth place behind ductal adenocarcinomas with cystic features, serous cystic neoplasms and mucinous cystic neoplasms. The most frequent cystic tumor-like lesions were pancreatitis-associated pseudocysts. New and rare entities that have recently been identified are mucinous nonneoplastic cysts, acinar cell cystadenomas and cystic hamartomas. Bearing in mind that figures from referral centers such as ours may be biased regarding the relative frequency of lesions, we concluded from our data that intraductal papillary-mucinous neoplasms are the most frequently occurring pancreatic cystic neoplasms, rather than solid pseudopapillary neoplasms. It was possible to classify all cystic lesions encountered in our files or described in the literature in a new system that distinguishes between neoplastic and nonneoplastic lesions, with further subdivisions into epithelial (adenomas, borderline neoplasms and carcinomas) and nonepithelial tumors. This classification is easy to handle and enables a distinction on the basis of clinical behavior and prognosis.

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Section: Discussionmentioning

confidence: 99%

Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal

et al. 2004

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“…A rare variant of acinar cell carcinoma (acinar cell cystadenocarcinoma) is composed of innumerable variably-sized cysts, each lined by neoplastic acinar cells. 98,[110][111][112] Zymogen granules are positive for periodic acidSchiff (PAS), resistant to diastase digestion (dPAS) in 95% of acinar cell carcinomas. In cases with typical histologic features, the finding of granular dPAS positivity in the apical cytoplasm may be sufficient to confirm the diagnosis; however, many acinar cell carcinomas do not contain sufficient quantities of zymogen granules for this stain to provide convincing results, and immunohistochemical staining is a much more specific and sensitive technique.…”

Section: Acinar Cell Carcinoma and Mixed Acinar Carcinomasmentioning

confidence: 99%

Nonductal neoplasms of the pancreas

2007

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Although the majority of pancreatic neoplasms are infiltrating ductal adenocarcinomas or other neoplasms with ductal differentiation, neoplasms with acinar, endocrine, mixed, or uncertain differentiation constitute a diverse and distinctive group. The most common and best-characterized nonductal neoplasms are pancreatic endocrine neoplasm, acinar cell carcinoma, pancreatoblastoma, and solid pseudopapillary neoplasm. This review details the clinical and pathologic features of these nonductal neoplasms, highlighting diagnostic criteria including the use of specific immunohistochemical stains to define the cellular differentiation of the neoplasms. Modern Pathology (2007) 20, S94-S112.

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“…The most common cystic tumors are intraductal papillary-mucinous neoplasms, serous cystic neoplasms, mucinous cystic neoplasms and solid pseudopapillary neoplasms. 2,3 Rare cystic neoplasms include acinar cell cystadenocarcinomas, 4 acinar cell cystadenomas, 5 cystic endocrine tumors 6 and cystic mesenchymal tumors. 7 The differential diagnosis of pancreatic cystic neoplasms, however, also includes pancreatic ductal adenocarcinomas with cystic changes.…”

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confidence: 99%

Pancreatic ductal adenocarcinomas with cystic features: neither rare nor uniform

et al. 2005

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Cystic tumors of the pancreas are uncommon but important because of their diverse pathology and biology. Their wide spectrum also includes cystic variants of otherwise solid tumors, such as cystic endocrine tumors, cystic acinar cell carcinomas and ductal adenocarcinomas with cystic changes. In this study, we screened pancreatic ductal adenocarcinomas and their variants for macrocystic changes and determined the nature of the cysts (neoplastic vs non-neoplastic). Of 483 tumors 38 (8%) had cystic features. The largest group consisted of 24 pancreatic ductal adenocarcinomas showing a large-gland pattern with small cysts whose diameter varied between 0.5 and 1.8 cm. The epithelial lining of these cysts was generally positive for CEA (83%) and/or MUC1 (71%) and MUC5AC (74%). p53 was positive in 57% of the cases. The second group of cystic tumors (8/483) showed degenerative cystic cavities with diameters ranging between 1 and 6 cm. This group consisted of poorly differentiated pancreatic ductal adenocarcinomas, undifferentiated carcinomas with or without osteoclast-like giant cells and one adenosquamous carcinoma. In the third group of cystic tumors there were four pancreatic ductal adenocarcinomas containing tumor-related retention cysts. Their epithelial cells were positive for MUC5AC, but negative for CEA, MUC1 and p53. The fourth group consisted of two pancreatic ductal adenocarcinomas showing closely attached pseudocysts caused by tumor-associated pancreatitis. The results indicate that a considerable number of pancreatic ductal adenocarcinomas and their variants display cystic features and must therefore be considered in the differential diagnosis of cystic neoplasms of the pancreas. Moreover, not all of the cystic structures we observed were neoplastic in nature. They may also represent nonneoplastic changes, such as retention cysts and inflammatory pseudocysts.

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Acinar cell cystadenocarcinoma of human pancreas

Cited by 88 publications

References 11 publications

Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal

Cystic neoplasms of the pancreas and tumor-like lesions with cystic features: a review of 418 cases and a classification proposal

Nonductal neoplasms of the pancreas

Pancreatic ductal adenocarcinomas with cystic features: neither rare nor uniform

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