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Acinic cell carcinoma of the lung

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Acinic cell carcinoma of the lung
Other namesFechner tumor, AcCC of the lung
Very high magnification micrograph of an acinic cell carcinoma, abbreviated AcCC. H&E stain.
SpecialtyOncology, Pulmonology

Acinic cell carcinoma of the lung is a very uncommon tumor that typically appears close to the right bronchus.[1] As of 2022, only 29 cases have been documented in the English literature[1] since Fechner et al. first described this entity in 1972.[2] Histologically similar to the major and minor salivary glands, pluripotent cells of the submucosal serous and mucous glands of the tracheobronchial tree are thought to be the source of acinic cell carcinoma of the lung. The histologic characteristics of acinic cell carcinoma of the lung are nearly identical to those of the salivary glands.[3]

Signs and symptoms

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Hemostasis and cough were the most common clinical symptoms. Many times, patients have no symptoms. Tumors were typically small, seldom growing larger than 4 cm. The right bronchus was most likely to be affected by the tumor, then the left bronchus and trachea.[4]

Diagnosis

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Prior to making a diagnosis of primary acinic cell carcinoma of the lung, a comprehensive clinical history, physical examination, and imaging studies are necessary due to the indolent nature of primary acinic cell carcinoma of the salivary gland and its potential for metastasis after extended latency.[5]

Primary acinic cell carcinoma of the lung is particularly difficult to diagnose histologically because the primary basis for the diagnosis is morphological features.[1] Fechner et al. initially reported on two cell populations in primary acinic cell carcinoma of the lung: a majority of light cells, akin to acinic cell tumor of the parotid gland, and dark cells, resembling normal serous cells of the bronchial submucosal glands.[2]

When compared to the traditional "blue dot" appearance of acinic cell carcinomas originating from the parotid gland,[6] the majority of primary pulmonary acinic cell carcinomas exhibit a mixture of clear and eosinophilic granular cytoplasm. This discrepancy can be attributed to the pulmonary submucosal gland's serous cells secreting a low concentration of peptides, proteins, and small organic molecules acting as antimicrobials, as well as the fact that they do not produce digestive zymogen.[7] As a result, PAS-D stain weak positivity or negativity was noted.[8][9] When assessing pulmonary ACC, immunohistochemical stains are not very useful because they show an immunoprofile that is typical of serous epithelial cells.[9] EMA and cytokeratins typically cause immunoreactivity in these tumors. S100, lysozyme, and chromogranin are all negative.[9][8] Amylase and α-1-antichymotrypsin have unreliable immunoreactivity.[4]

See also

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References

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  1. ^ a b c Nibid, Lorenzo; Frasca, Luca; Sabarese, Giovanna; Righi, Daniela; Taccogna, Silvia; Crucitti, Pierfilippo; Graziano, Paolo; Perrone, Giuseppe (2022). "DOG-1 positive primary acinic cell carcinoma of the lung and investigation of molecular status". Pathologica. 114 (5): 385–390. doi:10.32074/1591-951X-786. PMC 9614299. PMID 36305026.
  2. ^ a b RE, Fechner; BR, Bentinck; JB, Askew (1972). "Acinic cell tumor of the lung. A histologic and ultrastructural study". Cancer. 29 (2): 501–508. doi:10.1002/1097-0142(197202)29:2<501::aid-cncr2820290241>3.0.co;2-b. ISSN 0008-543X. PMID 4111143.
  3. ^ Cho, Junhun; Kim, Taeeun; Han, Joungho; Kim, Kwhanmien; Kim, Tae Sung (May 2010). "Primary Acinic Cell Carcinoma of the Lung: A Case Report" (PDF). Lung Cancer. 9 (1): 20–23. doi:10.6058/jlc.2010.9.1.20. Retrieved 28 December 2023.
  4. ^ a b Nie, Ling; Zhou, Chunlei; Wu, Hongyan; Zhou, Qiang; Meng, Fanqing (2019). "Primary Pulmonary Acinic Cell Carcinoma: A Clinicopathological Study of 6 Cases and Literature Review". International Journal of Surgical Pathology. 27 (6): 584–592. doi:10.1177/1066896919836499. ISSN 1066-8969. PMID 30898020. S2CID 85449102.
  5. ^ Ukoha, Ozuru O.; Quartararo, Paul; Carter, Darryl; Kashgarian, Michael; Ponn, Ronald B. (February 1, 1999). "Acinic Cell Carcinoma of the Lung With Metastasis to Lymph Nodes". Chest. 115 (2): 591–595. doi:10.1378/chest.115.2.591. ISSN 0012-3692. PMID 10027469.
  6. ^ S, Schwarz; J, Zenk; M, Müller; T, Ettl; PH, Wünsch; A, Hartmann; A, Agaimy (2012). "The many faces of acinic cell carcinomas of the salivary glands: a study of 40 cases relating histological and immunohistological subtypes to clinical parameters and prognosis". Histopathology. 61 (3): 395–408. doi:10.1111/j.1365-2559.2012.04233.x. ISSN 1365-2559. PMID 22551398. S2CID 45785380. Retrieved December 28, 2023.
  7. ^ JH, Widdicombe; JJ, Wine (2015). "Airway Gland Structure and Function". Physiological Reviews. 95 (4): 1241–1319. doi:10.1152/physrev.00039.2014. ISSN 1522-1210. PMID 26336032.
  8. ^ a b CA, Moran; S, Suster; MN, Koss (November 1992). "Acinic cell carcinoma of the lung ("Fechner tumor"). A clinicopathologic, immunohistochemical, and ultrastructural study of five cases". The American Journal of Surgical Pathology. 16 (11): 1039–1050. doi:10.1097/00000478-199211000-00002. ISSN 0147-5185. PMID 1471724. S2CID 9770643. Retrieved December 28, 2023.
  9. ^ a b c RM, Sabaratnam; R, Anunathan; D, Govender (2004). "Acinic cell carcinoma: an unusual cause of bronchial obstruction in a child". Pediatric and Developmental Pathology. 7 (5): 521–526. doi:10.1007/s10024-004-1014-z. ISSN 1093-5266. PMID 15568215. S2CID 12614542. Retrieved December 28, 2023.

Further reading

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