Skip to main content

Advertisement

SpringerLink
Log in

Clinicopathologic and Immunophenotypic Characterization of 25 Cases of Acinic Cell Carcinoma with High-Grade Transformation

  • Original Paper
  • Published:
Head and Neck Pathology Aims and scope Submit manuscript

Abstract

Acinic cell carcinoma (AiCC) with high-grade transformation is a rare variant of AiCC composed of both a conventional low-grade (LG) AiCC and a separate high-grade (HG) component. We describe here, the clinicopathologic and immunohistochemical features of 25 cases diagnosed between 1990 and 2015. Available tissue was analyzed and compared with a cohort of pure LG AiCC for the morphologic and immunophenotypic profile. Incidence was higher in females (1.8:1) than males with an overall mean age at presentation of 63.2 years. All tumors occurred in the parotid gland including 76 % with facial nerve trunk and branches involvement. Most patients were treated with extensive resection and adjuvant therapy. Local recurrence or distant metastasis occurred in most patients, with 72.7 % dead with disease (mean 2.9 years) and 3 patients alive with disease (mean 2.4 years). The majority of the tumors were composed of a LG microcystic AiCC and a HG component consisting of invasive lobules of undifferentiated cells with predominantly solid, cribriform, and glandular patterns. Acinic differentiation was still present in HG areas but aggressive features such as perineural invasion (76 %), lymphovascular invasion (62 %), positive margins (72 %), high mitotic rate, atypical mitoses and/or comedonecrosis (86 %) were easily identified. Compared to the pure LG AiCC, the cases with HG transformation showed significantly increased expression of cyclin-D1, p53 and Ki-67. Most HG areas of AiCC expressed membranous β-catenin (92 %) and were negative for p63 (three cases were focally positive), S100, SMA, androgen, and estrogen receptors. DOG1 expression was present in all LG AiCC tested with retained expression in 91 % of cases with HG transformation, supporting acinic differentiation in the HG foci. Recognition of AiCC with high-grade transformation is imperative as more aggressive clinical management is warranted.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ellis GL, Auclair PL. Tumors of the salivary glands. Atlas of tumor pathology, 3rd series, Fascicle 17. Washington: Armed Forces Institute of Pathology; 1996. p. 183.

    Google Scholar 

  2. Barnes L, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization classification of tumours. Pathology and genetics of head and neck tumours. Lyon: IARC Press; 2005.

    Google Scholar 

  3. Stanley RJ, Weiland LH, Olsen KD, Pearson BW. Dedifferentiated acinic cell (acinous) carcinoma of the parotid gland. Otolaryngol Head Neck Surg. 1988;98(2):155–61.

    Article  CAS  PubMed  Google Scholar 

  4. Nagao T. “Dedifferentiation’’ and high-grade transformation in salivary gland carcinomas. Head Neck Pathol. 2013;7:S37–47.

    Article  PubMed  Google Scholar 

  5. Henley JD, Geary WA, Jackson CL, Wu CD, Gnepp DR. Dedifferentiated acinic cell carcinoma of the parotid gland: a distinct rarely described entity. Hum Pathol. 1997;28(7):869–73.

    Article  CAS  PubMed  Google Scholar 

  6. Di Palma S, Corletto V, Lavarino C, Birindelli S, Pilotti S. Unilateral aneuploid dedifferentiated acinic cell carcinoma associated with bilateral-low grade diploid acinic cell carcinoma of the parotid gland. Virchows Arch. 1999;434(4):361–5.

    Article  PubMed  Google Scholar 

  7. Piana S, Cavazza A, Pedroni C, Scotti R, Serra L, Gardini G. Dedifferentiated acinic cell carcinoma of the parotid gland with myoepithelial features. Arch Pathol Lab Med. 2002;126(9):1104–5.

    PubMed  Google Scholar 

  8. Schultz AM, Thomas AB, Henley JD, Badve S. Pathologic quiz case: a 42-year-old man with right facial swelling and weakness. Dedifferentiated acinic cell carcinoma of the parotid gland. Arch Pathol Lab Med. 2004;128(3):e52–3.

    PubMed  Google Scholar 

  9. González-Peramato P, Jiménez-Heffernan JA, López-Ferrer P, Vicandi B, Viguer JM. Fine needle aspiration cytology of dedifferentiated acinic cell carcinoma of the parotid gland: a case report. Acta Cytol. 2006;50(1):105–8.

    Article  PubMed  Google Scholar 

  10. Johnykutty S, Miller CH, Hoda RS, Giampoli EJ. Fine-needle aspiration of dedifferentiated acinic cell carcinoma: report of a case with cyto-histological correlation. Diagn Cytopathol. 2009;37(10):763–8.

    Article  PubMed  Google Scholar 

  11. Skálová A, Sima R, Vanecek T, Muller S, et al. Acinic cell carcinoma with high-grade transformation: a report of 9 cases with immunohistochemical study and analysis of TP53 and HER-2/neu genes. Am J Surg Pathol. 2009;33(8):1137–45.

    Article  PubMed  Google Scholar 

  12. Hyun OJ, Yoo RI, Jung C-K, Kim SH, Chung SK. F-18 FDG PET/CT findings of dedifferentiated acinic cell carcinoma. Clin Nucl Med. 2010;35:473–4.

    Article  Google Scholar 

  13. Jain A, Alam K, Misra A, Maheshwari V. Dedifferentiated acinic cell tumour: the harlequin of salivary gland neoplasms—an unusual variant. BMJ Case Rep. 2013. doi:10.1136/bcr-2012-008434.

    Google Scholar 

  14. Chiosea SI, Griffith C, Assaad A, Seethala RR. The profile of acinic cell carcinoma after recognition of mammary analog secretory carcinoma. Am J Surg Pathol. 2012;36(3):343–50.

    Article  PubMed  Google Scholar 

  15. Costa AF, Altemani A, Hermsen M. Current concepts on dedifferentiation/high-grade transformation in salivary gland tumors. Pathol Res Int. 2011; Article ID 325965. doi:10.4061/2011/325965.

  16. Nasse D. Die Geschwülste der Speicheldrüsen und verwandte Tumoren des Kopfes. Arch Klin Chir. 1892;44:233–302.

    Google Scholar 

  17. Buxton RW, Maxwell JH, French AJ. Surgical treatment of epithelial tumors of the parotid gland. Surg Gynecol Obstet. 1953;97(4):401–6.

    CAS  PubMed  Google Scholar 

  18. Foote FW Jr, Frazell EL. Tumors of the major salivary glands. Cancer. 1953;6(6):1065–133.

    Article  PubMed  Google Scholar 

  19. Yemelyanova A, Vang R, Kshirsagar M, Lu D, et al. Immunohistochemical staining patterns of p53 can serve as a surrogate marker for TP53 mutations in ovarian carcinoma: an immunohistochemical and nucleotide sequencing analyisis. Mod Pathol. 2011;24(9):1248–53.

    Article  CAS  PubMed  Google Scholar 

  20. Chiosea SI, Williams L, Griffith CC, Thompson LD, et al. Molecular characterization of apocrine salivary duct carcinoma. Am J Surg Pathol. 2015;39(6):744–52.

    Article  PubMed  Google Scholar 

  21. Chênevert J, Duvvuri U, Chiosea S, Dacic S, et al. DOG1: a novel marker of salivary acinar and intercalated duct differentiation. Mod Pathol. 2012;25(7):919–29.

    Article  PubMed  Google Scholar 

  22. Chomette G, Auriol M, Vaillant JM. Acinic cell tumors of salivary glands. Frequency and morphological study. J Biol Buccale. 1984;12:157–69.

    CAS  PubMed  Google Scholar 

  23. Colmenero C, Patron M, Sierra I. Acinic cell carcinoma of the salivary glands: a review fo 20 new cases. J Cranio-Max-Fac Surg. 1991;19:260–6.

    Article  CAS  Google Scholar 

  24. el-Naggar AK, Abdul-Karim FW, Hurr K, Callender D, et al. Genetic alterations in acinic cell carcinoma of the parotid gland determined by microsatellite analysis. Genet Cytogenet. 1998;102(1):19–24.

    Article  CAS  Google Scholar 

  25. Spiro RH, Huvos AG, Strong EW. Acinic cell carcinoma of salivary origin. A clinicopathologic study of 67 cases. Cancer. 1978;41:924–35.

    Article  CAS  PubMed  Google Scholar 

  26. Perzin KH, LiVolsi VA. Acinic cell carcinomas arising in salivary glands. A clinicopathologic study. Cancer. 1979;44:1434–57.

    Article  CAS  PubMed  Google Scholar 

  27. Ellis GL, Corio RL. Acinic cell adenocarcinoma. A clinicopathologic analysis of 294 cases. Cancer. 1983;52:542–9.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, Woodland Hills, CA, USA

    Lester D. Thompson

  2. Department of Pathology, University of Michigan Health System, 2G332 UH, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA

    Muhammad N. Aslam, Jennifer N. Stall, Aaron M. Udager & Jonathan B. McHugh

  3. Department of Pathology, University of Pittsburgh Medical Center, Presbyterian University Hospital, Pittsburgh, PA, USA

    Simion Chiosea

Authors
  1. Lester D. Thompson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Muhammad N. Aslam
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jennifer N. Stall
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aaron M. Udager
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Simion Chiosea
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jonathan B. McHugh
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jonathan B. McHugh.

Ethics declarations

Conflict of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thompson, L.D., Aslam, M.N., Stall, J.N. et al. Clinicopathologic and Immunophenotypic Characterization of 25 Cases of Acinic Cell Carcinoma with High-Grade Transformation. Head and Neck Pathol 10, 152–160 (2016). https://doi.org/10.1007/s12105-015-0645-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12105-015-0645-x

Keywords

Search

Navigation