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| {{Infobox medical condition (new) | | {{Short description|A type of salivary gland cancer}} |
| | name = Acinic cell carcinoma
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| | image = Acinic cell carcinoma - high mag.jpg
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| | caption = [[Micrograph]] of an acinic cell carcinoma (right of image) and [[acinar gland]]s ([[parotid gland]] - left of image). [[H&E stain]]. | |
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| '''Acinic cell carcinoma''' is a malignant [[tumor]] representing 2% of all salivary tumors. 90% of the time found in the [[parotid gland]], 10% intraorally on buccal mucosa or palate. The disease presents as a slow growing mass, associated with pain or tenderness in 50% of the cases. Often appears pseudoencapsulated.
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| == Diagnosis ==
| | '''Acinic cell carcinoma''' is a rare type of [[salivary gland]] [[cancer]] that primarily affects the [[parotid gland]], which is the largest of the salivary glands located near the ear. This type of carcinoma is characterized by its slow growth and relatively low potential for metastasis compared to other salivary gland cancers. |
| Basophilic, bland cells similar to acinar cells. Growth pattern: solid - acinar cells, microcytic - small cystic spaces mucinous or eosinophilic, papillary-cystic - large cystic lined by epithelium, follicular - similar to thyroid tissue.
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| These tumors, which resemble serous acinar cells, vary in their behavior from locally aggressive to blatantly malignant. | | ==Pathophysiology== |
| | Acinic cell carcinoma arises from the [[acinar cells]] of the salivary glands, which are responsible for producing [[saliva]]. These tumors are typically composed of cells that resemble normal acinar cells, and they can exhibit a variety of growth patterns, including solid, microcystic, papillary-cystic, and follicular. |
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| It can also appear in the [[breast]]. The [[Acinar cell carcinoma of the pancreas|pancreatic form]] of acinic cell carcinoma is a rare subtype of exocrine pancreatic cancer. Exocrine pancreatic cancers are the most common form of pancreatic cancer when compared to endocrine pancreatic cancer.<ref name="pmid12101208">{{cite journal |vauthors=Coyne JD, Dervan PA |title=Primary acinic cell carcinoma of the breast |journal=J. Clin. Pathol. |volume=55 |issue=7 |pages=545–7 |date=July 2002 |pmid=12101208 |pmc=1769684 |doi= 10.1136/jcp.55.7.545|url=http://jcp.bmj.com/cgi/pmidlookup?view=long&pmid=12101208}}</ref>
| | The [[histology]] of acinic cell carcinoma is notable for its diversity, with tumor cells often showing granular cytoplasm due to the presence of [[zymogen granules]]. This feature can help distinguish acinic cell carcinoma from other types of salivary gland tumors. |
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| Acinic cell carcinomas arise most frequently in the parotid gland. Other sites of primary tumors have included the submandibular gland and other major and minor salivary glands. There have been rare cases of primary tumors involving the parapharyngeal space and the sublingual gland.<ref name='overview'>"[http://www.aciniccell.org/overview.html Acinic Cell Carcinoma Overview] {{Webarchive|url=https://web.archive.org/web/20091215053817/http://www.aciniccell.org/overview.html |date=2009-12-15 }}." Acinic Cell Carcinoma Information Center. Web. 07 Dec. 2009.</ref><ref name="ReferenceA">{{cite journal|last1=Chiosea|first1=SI|last2=Griffith|first2=C|last3=Assaad|first3=A|last4=Seethala|first4=RR|title=The profile of acinic cell carcinoma after recognition of mammary analog secretory carcinoma.|journal=The American Journal of Surgical Pathology|date=March 2012|volume=36|issue=3|pages=343–50|pmid=22301503|doi=10.1097/pas.0b013e318242a5b0}}</ref>
| | ==Clinical Presentation== |
| | Patients with acinic cell carcinoma often present with a painless, slow-growing mass in the region of the parotid gland. In some cases, the tumor may cause facial nerve dysfunction if it invades nearby structures. Other symptoms can include swelling, discomfort, or a feeling of fullness in the affected area. |
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| <gallery>
| | ==Diagnosis== |
| File:Acinic cell carcinoma.jpg | [[Micrograph]] of acinic cell carcinoma. [[Pap stain]]. [[Fine needle aspiration]] specimen.
| | The diagnosis of acinic cell carcinoma typically involves a combination of clinical evaluation, imaging studies, and [[biopsy]]. Imaging techniques such as [[ultrasound]], [[CT scan]], or [[MRI]] can help assess the extent of the tumor and its relationship to surrounding structures. A definitive diagnosis is made through histopathological examination of a biopsy specimen. |
| File:Acinic cell carcinoma - intermed mag.jpg | Intermed. mag.
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| File:Acinic cell carcinoma - very high mag.jpg | Very high mag.
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| </gallery>
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| ==Prognosis==
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| Prognosis is good for acinic cell carcinoma of the parotid gland, with five-year survival rates approaching 90%, and 20-year survival exceeding 50%. Patients with acinic cell carcinomas with high grade transformation (sometimes also called [[dedifferentiation]]) have significantly worse survival.<ref name="ReferenceA"/><ref>{{cite journal|last1=Thompson|first1=LDR|last2=Aslam|first2=MN|last3=Stall|first3=JN|last4=Udager|first4=AM|last5=Chiosea|first5=S|last6=McHugh|first6=JB|title=Clinicopathologic and Immunophenotypic Characterization of 25 Cases of Acinic Cell Carcinoma with High-Grade Transformation.|journal=Head and Neck Pathology|date=June 2016|volume=10|issue=2|pages=152–160|pmid=26245749|doi=10.1007/s12105-015-0645-x|pmc=4838973}}</ref>
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| The prognosis of an acinic cell carcinoma originating in the lung is much more guarded than cases of this rare histotype occurring in most other organs, but is still considerably better than for other types of [[lung cancer]].<ref name='who2004' />
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| ==Treatment== | | ==Treatment== |
| a) Surgical resection is mainstay of treatment, whenever possible. If tumor is completely removed, post-operative [[radiation therapy]] is typically not needed since acinic cell is considered a low-grade histology. Post-operative radiation therapy for acinic cell carcinoma is used if: 1) margins are positive, 2) incomplete resection, 3) tumor invades beyond gland, 4) positive lymph nodes.
| | The primary treatment for acinic cell carcinoma is surgical resection, often involving a [[parotidectomy]] to remove the affected gland. The extent of surgery depends on the size and location of the tumor, as well as its proximity to critical structures such as the facial nerve. |
| b) Neutron beam radiation
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| c) Conventional radiation
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| d) [[Chemotherapy]]
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| <ref name='overview' />
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| ==Epidemiology==
| | In some cases, [[radiation therapy]] may be recommended postoperatively, especially if there are concerns about residual disease or if the tumor exhibits aggressive features. [[Chemotherapy]] is generally not a primary treatment modality for acinic cell carcinoma but may be considered in cases of metastatic disease. |
| Acinic cell carcinoma appears in all age groups, but presents at a younger median age (approx. 52 years) than most other [[salivary gland cancer]]s. Occurrences in children are quite common.<ref name='overview' />
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| ==Acinic cell carcinoma of the lung== | | ==Prognosis== |
| [[Acinic cell carcinoma of the lung]] is a very rare variant of lung cancer that, in this organ, is classified among the [[salivary gland-like carcinoma of the lung]]. Fewer than 1% of malignancies beginning in the lower respiratory tract are acinic cell carcinomas.<ref name='who2004'>{{cite book |title=Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart |editor1-last=Travis |editor1-first=William D |editor2-last=Brambilla |editor2-first=Elisabeth |editor3-last=Muller-Hermelink |editor3-first=H Konrad |editor4-last=Harris |editor4-first=Curtis C |publisher=IARC Press |location=Lyon |year=2004 |series=World Health Organization Classification of Tumours |isbn=92-832-2418-3 |url=http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/bb10-cover.pdf |accessdate=27 March 2010 |archive-url=https://web.archive.org/web/20090823210304/http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/bb10-cover.pdf |archive-date=2009-08-23 |url-status=dead }}</ref>
| | The prognosis for patients with acinic cell carcinoma is generally favorable, with a high rate of long-term survival. However, the risk of recurrence and metastasis, although lower than in other salivary gland cancers, still exists. Factors influencing prognosis include tumor size, histological grade, and the presence of perineural invasion. |
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| ==References==
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| == External links == | | ==Related Pages== |
| {{Medical resources
| | * [[Salivary gland tumors]] |
| | DiseasesDB =
| | * [[Parotid gland]] |
| | ICD10 = {{ICD10|C|07||c|00}}
| | * [[Histopathology]] |
| | ICD9 = {{ICD9|142.0}}
| | * [[Oncology]] |
| | ICDO = M8550/3
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| * {{citation|title=Diagnostic Pathology: Head and Neck, 2 ed|last=Thompson|first=L.D.R.|publisher=[[Elsevier]]|year=2016|isbn=978-0323392556}} | |
| *{{cite book |author=Neville, Brad W. |title=Oral & maxillofacial pathology |publisher=W.B. Saunders |location=Philadelphia |year=2002 |pages= |isbn=0-7216-9003-3 |edition=2nd}} | |
| *Kahn, Michael A. Basic Oral and Maxillofacial Pathology. Volume 1. 2001. | |
| {{ICDOMorphology|state=collapsed}}
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| {{Tumors of lip, oral cavity and pharynx}}
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| [[Category:Salivary gland neoplasia]] | | [[Category:Salivary gland neoplasia]] |
| {{dictionary-stub1}}
| | [[Category:Head and neck cancer]] |
A type of salivary gland cancer
Acinic cell carcinoma is a rare type of salivary gland cancer that primarily affects the parotid gland, which is the largest of the salivary glands located near the ear. This type of carcinoma is characterized by its slow growth and relatively low potential for metastasis compared to other salivary gland cancers.
Pathophysiology
Acinic cell carcinoma arises from the acinar cells of the salivary glands, which are responsible for producing saliva. These tumors are typically composed of cells that resemble normal acinar cells, and they can exhibit a variety of growth patterns, including solid, microcystic, papillary-cystic, and follicular.
The histology of acinic cell carcinoma is notable for its diversity, with tumor cells often showing granular cytoplasm due to the presence of zymogen granules. This feature can help distinguish acinic cell carcinoma from other types of salivary gland tumors.
Clinical Presentation
Patients with acinic cell carcinoma often present with a painless, slow-growing mass in the region of the parotid gland. In some cases, the tumor may cause facial nerve dysfunction if it invades nearby structures. Other symptoms can include swelling, discomfort, or a feeling of fullness in the affected area.
Diagnosis
The diagnosis of acinic cell carcinoma typically involves a combination of clinical evaluation, imaging studies, and biopsy. Imaging techniques such as ultrasound, CT scan, or MRI can help assess the extent of the tumor and its relationship to surrounding structures. A definitive diagnosis is made through histopathological examination of a biopsy specimen.
Treatment
The primary treatment for acinic cell carcinoma is surgical resection, often involving a parotidectomy to remove the affected gland. The extent of surgery depends on the size and location of the tumor, as well as its proximity to critical structures such as the facial nerve.
In some cases, radiation therapy may be recommended postoperatively, especially if there are concerns about residual disease or if the tumor exhibits aggressive features. Chemotherapy is generally not a primary treatment modality for acinic cell carcinoma but may be considered in cases of metastatic disease.
Prognosis
The prognosis for patients with acinic cell carcinoma is generally favorable, with a high rate of long-term survival. However, the risk of recurrence and metastasis, although lower than in other salivary gland cancers, still exists. Factors influencing prognosis include tumor size, histological grade, and the presence of perineural invasion.
Related Pages
