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Acinar cell carcinomas (ACCs) of the pancreas are a rare tumor accounting for only about 2% of all pancreas tumors. Chen AL , Misdraji J , Brugge WR , Ferrone CR , Pitman MB Diagn Cytopathol , 45(6):557-560, 25 Feb 2017 Original cytologic diagnoses included “acinar cell carcinoma,” “pancreatic endocrine tumor,” “favor neuroendocrine tumor, low-grade” and “non-diagnostic specimen.” The cytologic features included small to moderate-sized loose groups with numerous single cells, prominent acinar formation, little anisonucleosis and prominent nucleoli. Ductal cells. Various studies have reported the characteristic cytologic features of ACC as tight clusters of hyperchromatic epithelial cells with hyaline globules having a smooth sharp border. Malignancies of epithelial origin are termed carcinoma PMID: 20182344. 1988 Jun 1;61(11):2278-85. Cytology slide circulation: 60% SCA (IVA), 40% SCA/NET (IVA-IVB) Case 5 - histology ... • Acinar cell carcinoma • Serous cystadenoma. Acinar cells: large cells with serous or mucinous cytoplasmic content and small nuclei. Christopher D.M. 2010 Apr;34(4):510-8. Conclusions: Acinar cell carcinoma has a distinctive cytological appearance but is frequently misdiagnosed on cytology. small nucleolus (larger if reactive) Immunocytochemistry is useful … Recognize whether a cell or tissue is basophilic or eosinophilic. From: Cytology of Normal Pancreas. acinar cell aggregates. Author / Update. Case 7 - cytology 50 y.o. Cancer. nuclear features. It is also known as acinic cell adenocarcinoma . The inflammatory component usually consists of mononuclear cells and histiocytes. cytology and histology of columnar epithelial cells. Cytology showed numerous erythrocytes, small lymphocytes, and neutrophils consistent with blood contamination. Author / Update. There have been only a few retrospective reports on its cytological features. Background: Acinar cell carcinoma of the pancreas is a rare neoplasm. Tianjin Medical University Cancer Institute and Hospital pathology database was reviewed from 1995 to 2015, … Pancreatic acinar cell carcinomas with prominent ductal differentiation: Mixed acinar ductal carcinoma and mixed acinar endocrine ductal carcinoma. Aspirates of chronic pancreatitis are not typically very cellular; they consist of varying amounts of inflammatory cells, ductal cells, acinar cells, calcifications, fibrous tissue fragments , and debris. We describe the cytologic features of cases we have seen, review the literature regarding its cytologic features and discuss the pitfalls that may be encountered and the use of immunohistochemistry for its diagnosis. Aspiration smear composed of oncocytic cells with dense granular cytoplasm (a: Giemsa, ×400) diagnosed as oncocytoma. 3) Plasmacytic tumours. The cytologic features included small to moderate-sized loose groups with numerous single cells, prominent acinar formation, little anisonucleosis and prominent nucleoli. 1 - 20 de 241 Acinar cell carcinoma Pancreatoblastoma Lymphoma, plasmacytoma Metastasis Mixed Solid and Cystic Benign/Non-Neoplastic Mucinous cystic Groove pancreatitis Neoplastic Solid-pseudopapillary neoplasm Neuroendocrine tumors Ductal adenocarcinoma Acinar cell carcinoma Metastases and secondary tumors Cystic Benign/Non-Neoplastic Mature teratoma Conclusion: The cytology of acinar cell carcinoma shares features with aspirates of other nonductal adenocarcinoma neoplasms of the pancreas. Acinic cell carcinoma. The acinar arrangement appeared to be a characteristic Histologic and IM studies of the excised tumors from pa- feature of angiosarcoma cells, not only in materials obtained tients 1 and 2 revealed a subcutaneous moderately differ- by needle aspiration but also in other cytologic materials. Case 7 - … Fig 2. They appear as two-dimensional sheet of cells with a “honeycomb” pattern. Cytologic diagnostic features. eccentric. Zymogen granules are often seen in the cytoplasm. Both tumors can present with similar cytomorphologic features, and both tumors can be presented with positivity for cytokeratin and for neuroendocrine markers. Transport / … Acinar cell cystadenoma is a rare, benign cystic lesion of the pancreas. Stelow EB, Shaco-Levy R, Bao F, Garcia J, Klimstra DS. Both tumors can present with similar cytomorphologic features, and both tumors can be presented with positivity for cytokeratin and for neuroendocrine markers. We emphasize possible diagnostic pitfalls of … An introduction to cytopathology is in the cytopathology article. Acinar cell carcinoma (ACC) and islet cell tumor (ICT), both rare pancreatic neoplasms, can be diagnosed accurately and rapidly with the use of imaging‐guided fine‐needle aspiration biopsies. Cytological features were described for 16 histologically proven malignant acinar cell neoplasms: acinar cell carcinoma (8 cases), mixed acinar-neuroendocrine carcinoma (6 cases), mixed acinar-ductal carcinoma (1 case), and pancreatoblastoma (1 case).The majority of aspirates from acinar cell cystadenomas were nondiagnostic or negative (5 of 6 cases; 83%). A clue to the diagnosis is that tumors show high Ki67 indices and a diagnosis of MAEC should be excluded anytime a diagnosis of Grade 2 or 3 well-differentiated neuroendo … A clue to the diagnosis is that tumors show high Ki67 indices and a diagnosis of MAEC should be excluded anytime a diagnosis of Grade 2 or 3 well-differentiated neuroendocrine tumor or high-grade neuroendocrine carcinoma … Aspirates from these tumors can be diagnostically challenging. Acinic cell carcinoma, on cytology, shows acinic cells with vacuolated cytoplasm and anisonucleosis and bare nuclei in the background. Acinar cell carcinoma (ACC) of the pancreas is extremely uncommon and its cytologic features have rarely been described. Acinic cell carcinoma is an uncommon malignant neoplasm, mostly arising in the parotid gland. Cell Associations. We describe the cytologic features of cases we have seen, review the literature regarding its cytologic features and discuss the pitfalls that may be encountered and the use of immunohistochemistry for its diagnosis. 5) Transmissible Venereal Tumour. Smear showed hypocellular aspirate with scant acinar cells in a background of lymphocytes and macrophages. Original cytologic diagnoses included "acinar cell carcinoma," "pancreatic endocrine tumor," "favor neuroendocrine tumor, low-grade" and "non-diagnostic specimen." We present the first case of acinar cell cystadenoma in a 65-year-old woman, diagnosed pre-operatively by pancreatic cyst fluid cytology and Moray ® micro-forceps biopsy. fine even chromatin. Fig 2. No abnormal lymphocytes were seen and flow cytometry showed no lymphoma. Fletcher MD, FRCPath, in Diagnostic Histopathology of Tumors, 2021 Acinar Cell Carcinoma and Related Neoplasms. Clusters (adherent); can see acinar formation if secretory: Individual cells, or in some non-cohesive aggregates: Individual cells; may form aggregate-like arrangements in thicker aspirates: Clusters (adherent); can see acinar formations in endocrine tumors: Cell Shapes. H&E stain. Atypical and neoplastic acinar cell lesions of the pancreas in an autopsy study of Japanese patients. Acinar cells. Acinar cell carcinoma (ACC) is a relatively rare pancreatic neoplasm with poorly defined prognosis. There have been only a few retrospective reports on its cytological features. These further confirm the difficulty of diagnosis of acinar cell carcinoma based on cytology alone. Acinar cell carcinoma is a solid epithelial neoplasm with acinar differentiation, accounting for about 1% to 2% of pancreatic neoplasms (see Table 11.1).It occurs mostly in adults in the sixth to eighth decades and predominantly in male patients, … 1) Mast cell tumour. Diagnosis of acinar cell carcinoma (ACC) in small cytology samples can be challenging and can be confused with the diagnosis of pancreatic neuroendocrine tumors (PNET). Original posting/last update: 1/9/08, 12/28/13. This study aimed to investigate this rare pancreatic neoplasm through comparing patients with ACC to pancreatic ductal cell adenocarcinoma (DCA). Acinic cell carcinoma is an uncommon malignant neoplasm, mostly arising in the parotid gland. Am J Surg Pathol. RESULTS: Cytological features were described for 16 histologically proven malignant acinar cell neoplasms: acinar cell carcinoma (8 cases), mixed acinar-neuroendocrine carcinoma (6 cases), mixed acinar-ductal carci-noma (1 case), and pancreatoblastoma (1 case).The majority of aspirates from acinar cell cystadenomas were nondiagnos- Acinar cell carcinoma (ACC) of the pancreas is extremely uncommon and its cytologic features have rarely been described. Acinar cell carcinoma. Acinar cell cystadenoma is a rare, benign cystic lesion of the pancreas. Acinar cell carcinomas morphologically resemble tumors of a neuroendocrine feature such as PDAs, NETs, and SPTs, and for this reason, the accurate diagnosis rate of ACC based on cytological findings is low. Histopathology of the gastrointestinal tract is dealt with in gastrointestinal pathology. Aspirates from these tumors can be diagnostically challenging. Cytologic diagnostic features. Recognized as morphologically distinct from acinar cells, centroacinar cells are smaller than acinar cells (≈10 µm in diameter), have a high nuclear-to-cytoplasm ratio, and have long cytoplasmic processes that allow contact with other cells (i.e., centroacinar, acinar, and islet cells) (Cleveland et al, 2012; Leeson & Leeson, 1986; Pour, 1994). (B) Cell block of acinar cell carcinoma with sheets and trabeculae of neoplastic cells (hematoxylin-eosin stain, ×200 magnification), which are positive for (C) trypsin immunohistochemical stains. Christopher D.M. CASE N°24 – Biliary Tract Brush Cytology – Malignant vs. Reactive cells CASE N°25 – Adenocarcinoma in bronchial washing CASE N°26 – Ovarian carcinoma with psammoma bodies in ascites In addition to the acinar cells, a polymorphous population 76 cases belonged in this category. of acinar cells, oncocytic cells and clear cells.4 In case 1, there was a population of oval to polygonal shaped acinar cells with well-defined cell boundaries with moderate amount of cytoplasm showing fine azurophilic granules visualised on MGG stained smears. There have been only a few retrospective reports on its cytological features. Individual cells are with granular cytoplasm, round nuclei and fine granular chromatin(Fig.2). Membrane-bound vesicles often with a protein coat for transport and/or export. Cytology OBJECTIVES: At the end of this section you should be able to: 1. Case 7 - cytology Synaptophysin Chromogranin. Acinar cell carcinoma of the pancreas metastatic to the ovary: a report of 4 cases. Fletcher MD, FRCPath, in Diagnostic Histopathology of Tumors, 2021 Acinar Cell Carcinoma and Related Neoplasms. The cytology of acinar cell carcinoma shares features with aspirates of other nonductal adenocarcinoma neoplasms of the pancreas. They appear as variably-sized cohesive groups of cells, sometimes with central lumen (Fig.1). This article deals only with gastrointestinal cytopathology. Additionally, many clusters of large cells were seen with plentiful cytoplasm, round to oval nucleus, and open chromatin. Original posting/last update: 1/9/08, 12/28/13. mh:"Acinar Cells/cytology" (241) : 20 | 50 | 100 20 | 50 | 100. Ductal cells. Important … One of the unique features associated with EUS FNA is the presence of a variable number of normal GI epithelial cells and other benign cells from the target organs. Acinar cell cystadenomas are indolent tumors that are discovered incidentally at a mean age of 49 years with female predilection. Acinar cell carcinoma. Acinar cell carcinoma tumors Cystic Benign/Non-Neoplastic teratoma Epidermoid cyst in ectopic spleen Lymphoepithelial cyst Pseudocyst Serous cystic neoplasm Acinar cell Squamoid cyst of pancreatic ducts Intraductal papillary mucinous neoplasms Mucinous cystic neoplasms Cystic neuroendocrine tumors cystadenocarcinoma 2) Lymphoid tumours. On morphology, dual-cell populations in … This slide contains many typical polarized protein synthesizing and secreting cells ( acinar cells of the pancreas). The benign neoplastic category included pleomorphic adenoma (PA), Warthin tumor, oncocytoma, and other unspecified benign lesions. Murine Cytomegalovirus MCK-2 Facilitates In Vivo Infection Transfer from Dendritic Cells to Salivary Gland Acinar Cells. In cytology, cells that are properly smeared and stained can be described as “fried eggs” because of the similarity in the appearance of ... secretory vacuoles and/or acinar formation may be seen in cell preparations taken from tumors originating from glandular epithelium. The lesions that have to be considered in the … Fig.1. They appear as variably-sized cohesive groups of cells, sometimes with central lumen (Fig.1). Diagnosis of acinar cell carcinoma (ACC) in small cytology samples can be challenging and can be confused with the diagnosis of pancreatic neuroendocrine tumors (PNET). Cancer. Individual cells are with granular cytoplasm, round nuclei and fine granular chromatin(Fig.2). Robert V Rouse MD Department of Pathology Stanford University School of Medicine Stanford CA 94305-5342 . Cytology of Acinar Cell Neoplasms/Sigel and Klimstra Cancer Cytopathology August 2013 461. nucleoli were expected to be a consistent finding, but 1 case exhibited multiple nucleoli in the majority of cells and2caseslackednucleoli(Figs.2Aand2B). Groups of cells in nests, cords or acini; Single cells; Nuclear irregularity, crowding, overlapping; Increased N/C ratio; Conspicuous nucleoli; Moderately abundant granular cytoplasm Acinar Cell Carcinoma Carcinoma showing Acinar cell differentiation Most commonly older men Lobular to trabecular pattern of growth, very cellular Cells have moderate amounts of granular cytoplasm (full of zymogen granules) with uniform nuclei and a single prominent nucleolus Can be mixed with neuroendocrine or ductal carcinomas Zymogen granules are often seen in the cytoplasm. Although this tumor has been well characterized histologically, the morphological patterns in Fine Needle Aspiration Cytology have not been well defined. round. entiated angiosarcoma. Table 3.2 Differential diagnosis and pitfalls of benign acinar cells. Robert V Rouse MD Department of Pathology Stanford University School of Medicine Stanford CA 94305-5342 . Cytoskeleton. 55 Islet cells are sparse or absent. Original cytologic diagnoses included “acinar cell carcinoma,” “pancreatic endocrine tumor,” “favor neuroendocrine tumor, low‐grade” and “non‐diagnostic specimen.” The cytologic features included small to moderate‐sized loose groups with numerous single cells, prominent acinar formation, little anisonucleosis and prominent nucleoli. Gastrointestinal cytopathology, also known as GI cytology, is a relatively small part of cytopathology.. We describe the cytologic features of cases we have seen, review the literature regarding its cytologic features and discuss the pitfalls that may be encountered and the use of immunohistochemistry for its diagnosis. Atypical and neoplastic acinar cell lesions of the pancreas in an autopsy study of Japanese patients. Histology of the same case as (a) showing vacuolated acinar cells along with few oncocytic cells (b: Arrow, … Fine-needle aspiration (FNA) cytology is commonly used to evaluate salivary gland lesions and is considered to be highly accurate in the diagnosis of salivary gland tumors. Cytology of acinar cell carcinoma may overlap with that of pancreatic neuroendocrine tumors. It is a rare, aggressive malignancy, usually arising in adults, but it has been reported in children and adolescents as well. Original cytologic diagnoses included “acinar cell carcinoma,” “pancreatic endocrine tumor,” “favor neuroendocrine tumor, low-grade” and “non-diagnostic specimen.” The cytologic features included small to moderate-sized loose groups with numerous single cells, prominent acinar formation, little anisonucleosis and prominent nucleoli. • Acinar cell carcinoma (zymogens) • Oncocytic/Hürthle cell neoplasms (mitochondria) • Neuroendocrine tumors (neurosecretory granules) • Hepatocytes/tumors • Melanoma (melanosomes) • Adrenal cortical/tumors • Leydig cells/tumors Based on: The Book of Cells: A Breviary of Cytopathology, by Dr. Richard Mac DeMay Tigroid Background (A) Acinar cell carcinoma showing nuclear pleomorphism and cells with a single prominent nucleolus (Papanicolaou stain, ×600 magnification). • Acinar cell carcinoma (zymogens) • Oncocytic/Hürthle cell neoplasms (mitochondria) • Neuroendocrine tumors (neurosecretory granules) • Hepatocytes/tumors • Melanoma (melanosomes) • Adrenal cortical/tumors • Leydig cells/tumors Based on: The Book of Cells: A Breviary of Cytopathology, by Dr. Richard Mac DeMay Tigroid Background Acinic cell carcinoma, abbreviated AcCC, is a rare type of salivary gland cancer. It is a rare, aggressive malignancy, usually arising in adults, but it has been reported in children and adolescents as well. Cytosol. It is very important to find ductal cells related to the acinic ones because if the former are missing we have to think of a well differentiated acinic cell carcinoma. normal pancreas. indistinct borders. This carcinoma shows positivity for trypsin, chymotrypsin, and BCL10. Fine-needle aspiration (FNA) cytology is commonly used to evaluate salivary gland lesions and is considered to be highly accurate in the diagnosis of salivary gland tumors. 1988 Jun 1;61(11):2278-85. It should not to be confused with pancreatic acinar cell carcinoma . male Pancreatic FNAB Uncinate process tumour, well demarcated. The lesions that have to be considered in the … 4) Histiocytic tumours. with loosely cohesive groups, acinar formations, and single cells or naked nuclei. fibrovascular stroma. Acinar cells. includes microfilaments, intermediate filaments, and microtubules. Because ACCs morphologically resemble neuroendocrine tumors (NETs) and solid pseudopapillary tumors (SPTs), differential diagnosis of ACC based on the cytological findings has been reported to be difficult. [1,2,3] Sigel and Klimstra have reported a discrepancy between the cytological and histological diagnoses in 14 of the 29 cases of malignant acinar tumors of the … Cytological features of round cells. They appear as two-dimensional sheet of cells with a “honeycomb” pattern. The specific cytologic features of these tumors are described in a series of 17 patients, and histologic and immunocytochemical correlations are discussed. Acinar cell cystadenoma: A challenging cytology diagnosis, facilitated by moray ® micro-forceps biopsy. The prognostic significance of these extremely well-differentiated ciliated tumor cells will be known only with long-term follow-up of the patient and analysis of more such tumors. Everything contained within the cell membrane (cytosol + organelles) Cytoplasm. The pancreatic parenchyma is composed predominantly of acinar cells; however, acinar cell neoplasms are rare. https://www.pathologyoutlines.com/topic/pancreasacinar.html Types of round cell tumours. Fig.1. plasma cells, mast cells. Lining cells are transitional, PASd negative No goblet cells; Cytologically bland; Probably forms a spectrum with nested variant urothelial carcinoma (fewer cysts and spaces) and with microcystic urothelial carcinoma All three are aggresive, invasive carcinomas in spite of their bland cytology; Robert V Rouse MD Department of Pathology Acinar cell carcinoma (ACC) of the pancreas is extremely uncommon and its cytologic features have rarely been described. The cells were positive for cytokeratin 7, and the cilia were highlighted by epithelial membrane antigen staining. ... Other case on cytology showed atypical cells mimicking as malignancy. 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