Acinar Cell Carcinoma of the Pancreas: Clinical and Cytomorphologic Characteristics
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Acinar cell carcinoma is a rare malignant epithelial neoplasm with predominantly exocrine acinar differentiation and is seen primarily in older men (mean age, 62 years). The presenting symptoms are usually non-specific, and jaundice is often not present. Symptoms relating to the overproduction and release of lipase into the circulation are present in 10-15% of patients. Characteristic cytomorphologic features include a population of cells with minimal pleomorphism, eccentrically placed nuclei with a single prominent nucleoli and moderate hyperchromasia. The cytoplasm is finely granular, and the background may contain granular debris secondary to cytolysis. A significant proportion of the cases also have a minor neuroendocrine component or scattered neuroendocrine cells. Approximately 50% of patients have metastatic disease at presentation, often restricted to the regional lymph nodes and liver. The prognosis is poor, only slightly better than that of pancreatic ductal adenocarcinoma.
Abstract
Acinar cell carcinoma is a rare malignant epithelial neoplasm with predominantly exocrine acinar differentiation and is seen primarily in older men (mean age, 62 years). The presenting symptoms are usually non-specific, and jaundice is often not present. Symptoms relating to the overproduction and release of lipase into the circulation are present in 10-15% of patients. Characteristic cytomorphologic features include a population of cells with minimal pleomorphism, eccentrically placed nuclei with a single prominent nucleoli and moderate hyperchromasia. The cytoplasm is finely granular, and the background may contain granular debris secondary to cytolysis. A significant proportion of the cases also have a minor neuroendocrine component or scattered neuroendocrine cells. Approximately 50% of patients have metastatic disease at presentation, often restricted to the regional lymph nodes and liver. The prognosis is poor, only slightly better than that of pancreatic ductal adenocarcinoma.
참고문헌 (41)
- Klimstra DS, "Nonductal neoplasms of the pancreas", Mod Pathol, 20(Suppl 1), pp.94~112 (2007)
- Klimstra DS, "Cell lineage in pancreatic neoplasm, In Pancreatic cancer: advances in molecular pathology, diagnosis and clinical management", pp.21~47 (1998), Biotechniques Books
- Ohike N, "Exocrine pancreatic neoplasms of nonductal origin: acinar cell carcinoma, pancreatoblastoma, and solid-pseudopapillary neoplasm", Surg Pathol Clin, 4, pp.579~588 (2011)
- Albores-Saavedra J, "Acinar cystadenoma of the pancreas: a previously undescribed tumor", Ann Diagn Pathol, 6, pp.113~115 (2002)
- Zamboni G, "Acinar cell cystadenoma of the pancreas: a new entity?", Am J Surg Pathol, 26, pp.698~704 (2002)
- Chatelain D, "Unilocular acinar cell cystadenoma of the pancreas an unusual acinar cell tumor", Am J Clin Pathol, 118, pp.211~214 (2002)
- Hruban RH, "AFIP atlas of tumor pathology series 4 fascicle 6: tumors of the pancreas" (2007), American Registry of Pathology
- Wisnoski NC, "672 patients with acinar cell carcinoma of the pancreas: a populationbased comparison to pancreatic adenocarcinoma", Surgery, 144, pp.141~148 (2008)
- Schmidt CM, "Acinar cell carcinoma of the pancreas in the United States: prognostic factors and comparison to ductal adenocarcinoma", J Gastrointest Surg, 12, pp.2078~2086 (2008)
- Holen KD, "Clinical characteristics and outcomes from an institutional series of acinar cell carcinoma of the pancreas and related tumors", J Clin Oncol, 20, pp.4673~4678 (2002)
- Hoorens A, "Pancreatic acinar cell carcinoma: an analysis of cell lineage markers, p53 expression, and Ki-ras mutation", Am J Pathol, 143, pp.685~698 (1993)
- Ambrosini-Spaltro A, "Pancreatictype acinar cell carcinoma of the stomach beneath a focus of pancreatic metaplasia of the gastric mucosa", Hum Pathol, 40, pp.746~749 (2009)
- Terris B, "Acinar cell carcinoma: a possible diagnosis in patients without intrapancreatic tumour", Dig Liver Dis, 43, pp.971~974 (2011)
- Coyne JD, "Pure pancreatic-type acinar cell carcinoma of the stomach: a case report", Int J Surg Pathol, 20, pp.71~73 (2012)
- Agaimy A, "Pancreatic-type acinar cell carcinoma of the liver: a clinicopathologic study of four patients", Mod Pathol, 24, pp.1620~1626 (2011)
- Burns WA, "Lipase-secreting acinar cell carcinoma of the pancreas with polyarthropathy: a light and electron microscopic, histochemical, and biochemical study", Cancer, 33, pp.1002~1009 (1974)
- Takanami K, "Two cases of 18 F-FDG PET", CT findings in acinar cell carcinoma of the pancreas, 2009, pp.34, 209~212
- Tapia B, "Acinar cell carcinoma versus solid pseudopapillary tumor of the pancreas in children: a comparison of two rare and overlapping entities with review of the literature", Pediatr Dev Pathol, 11, pp.384~390 (2008)
- Mergo PJ, "Pancreatic neoplasms: MR imaging and pathologic correlation", Radiographics, 17, pp.281~301 (1997)
- Matos JM, "Pancreatic acinar cell carcinoma: a multi-institutional study", J Gastrointest Surg, 13, pp.1495~1502 (2009)
- Shah S, "Uncommon solid pancreatic neoplasms: ultrasound, computed tomography, and magnetic resonance imaging features", Semin Ultrasound CT MR, 28, pp.357~370 (2007)
- García-Romero D, "Pancreatic panniculitis", Dermatol Clin, 26, pp.465~470 (2008)
- Kolb-van Harten P, "Pancreatic acinar cell carcinoma with excessive alpha-fetoprotein expression", Pancreatology, 7, pp.370~372 (2007)
- Hiraoka A, "Huge pancreatic acinar cell carcinoma with high levels of AFP and fucosylated AFP (AFPL3)", Intern Med, 51, pp.1341~1349 (2012)
- Kitagami H, "Acinar cell carcinoma of the pancreas: clinical analysis of 115 patients from Pancreatic Cancer Registry of Japan Pancreas Society", Pancreas, 35, pp.42~46 (2007)
- Klimstra DS, "Acinar cell carcinoma of the pancreas: a clinicopathologic study of 28 cases", Am J Surg Pathol, 16, pp.815~837 (1992)
- Seth AK, "Acinar cell carcinoma of the pancreas: an institutional series of resected patients and review of the current literature", J Gastrointest Surg, 12, pp.1061~1067 (2008)
- Hartwig W, "Acinar cell carcinoma of the pancreas: is resection justified even in limited metastatic disease?", Am J Surg, 202, pp.23~27 (2011)
- de Wilde RF, "Analysis of LKB1 mutations and other molecular alterations in pancreatic acinar cell carcinoma", Mod Pathol, 24, pp.1229~1236 (2011)
- Lowery MA, "Acinar cell carcinoma of the pancreas: new genetic and treatment insights into a rare malignancy", Oncologist, 16, pp.1714~1720 (2011)
- Abraham SC, "Genetic and immunohistochemical analysis of pancreatic acinar cell carcinoma: frequent allelic loss on chromosome 11p and alterations in the APC", beta-catenin pathway, 2002, pp.160, 953~962
- Falcone A, "Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest", J Clin Oncol, 25, pp.1670~1676 (2007)
- Conroy T, "FOLFIRINOX versus gemcitabine for metastatic pancreatic cancer", N Engl J Med, 364, pp.1817~1825 (2011)
- Roldo C, "MicroRNA expression abnormalities in pancreatic endocrine and acinar tumors are associated with distinctive pathologic features and clinical behavior", J Clin Oncol, 24, pp.4677~4684 (2006)
- Sandgren EP, "Pancreatic tumor pathogenesis reflects the causative genetic lesion", Proc Natl Acad Sci U S A, 88, pp.93~97 (1991)
- Ohike N, "Pathological assessment of pancreatic endocrine tumors for metastatic potential and clinical prognosis", Endocr Pathol, 16, pp.33~40 (2005)
- Ohike N, "Mixed acinar-endocrine carcinoma of the pancreas: a clinicopathological study and comparison with acinar-cell carcinoma", Virchows Arch, 445, pp.231~235 (2004)
- Bosman FT, "WHO classification of tumours of the digestive system", pp.314~330 (2010), IARC Press
- Stelow EB, "Pancreatic acinar cell carcinomas with prominent ductal differentiation: mixed acinar ductal carcinoma and mixed acinar endocrine ductal carcinoma", Am J Surg Pathol, 34, pp.510~518 (2010)
- Shimoike T, "Acinar-islet cell carcinoma presenting as insulinoma", J Gastroenterol, 32, pp.830~835 (1997)
- Seki Y, "Four cases of pancreatic acinar cell carcinoma treated with gemcitabine or S-1 as a single agent", Jpn J Clin Oncol, 39, pp.751~755 (2009)
