Solid and cystic acinar cell tumour of the pancreas
- 62 Downloads
- 107 Citations
Summary
The clinico-pathological features of five cases with a distinctive pancreatic tumour are presented. The tumours, which occurred only in young women and an adolescent girl, were of large size (2.5–10 cm), had an uncharacteristic symptomatology and showed fibrous encapsulation with no evidence of metastases. The histological features include (1) solid areas with a monomorphic cell pattern and intracellular PAS positive globules, and (2) large foci of degeneration with cystic necroses, haemorrhages and cholesterol granulomas. Some tumour cells were positive for α1-antitrypsin. The ultrastructural demonstration of zymogen-like granules suggests an acinar origin for the tumours. We therefore propose the term solid and cystic acinar cell tumour. This tumour resembles the so called pancreatoblastomas in small children in some respects. It must be clearly distinguished, on the other hand, from acinar cell carcinoma with its acinic structures and poor prognosis. This lesion is not included in the WHO classification of pancreatic neoplasms.
Key words
Pancreas tumours Young women Acinar cell origin Classification PrognosisPreview
Unable to display preview. Download preview PDF.
References
- Becker V (1973) Bauchspeicheldrüse (Inselapparat ausgenommen). In: Doerr W, Seifert G. Uehlinger E (eds) Spezielle pathologische Anatomie, Bd 6. Springer, Berlin-Heidelberg-New YorkGoogle Scholar
- Becker WF (1957) Pancreatoduodenectomy for carcinoma of the pancreas in an infant: report of a case. Ann Surg 145:864–870Google Scholar
- Benjamin E, Wright DH (1980) Adenocarcinoma of the pancreas of childhood: a report of two cases. Histopathology 4:87–104Google Scholar
- Boor PJ, Swanson MR (1979) Papillary-cystic neoplasm of the pancreas. Am J Surg Pathol 3:69–75Google Scholar
- Burns WA, Matthews MJ, Hamosh M, Vanderweide G, Blum R, Johnson FB (1974) Lipase secreting acinar cell carcinoma of the pancreas with polyarthropathy — a light and electron microscopic, histochemical and biochemical study. Cancer 33:1002–1009Google Scholar
- Cubilla AL, Fitzgerald PJ (1979) Classification of pancreatic cancer (nonendocrine). Mayo Clin Proc 54:449–458Google Scholar
- Frable WJ, Still WJS, Kay S (1971) Carcinoma of the pancreas, infantile type. A light and electron microscopic study. Cancer 27:667–673Google Scholar
- Frantz VK (1959) Tumour of the pancreas. In: Atlas of tumor pathology VII, fasc. 27 and 38. Armed Forces Institute of Pathology, Washington DCGoogle Scholar
- Gibson JB, Sobin LH (1978) Histological typing of tumours of the liver, biliary tract and pancreas. WHO, International Histological Classification of Tumours, No 20. World Health Organization, GenevaGoogle Scholar
- Hamoudi AB, Misugi K, Grosfeld JL, Reiner CB (1970) Papillary epithelial neoplasm of pancreas in a child. Cancer 26:1126–1134Google Scholar
- Horie A, Yano Y, Kotoo Y, Miwa A (1977) Morphogenesis of pancreatoblastoma, infantile carcinoma of the pancreas. Report of two cases. Cancer 39:247–254Google Scholar
- Klöppel G, Bommer G, Commandeur G, Heitz Ph (1978) The endocrine pancreas in chronic pancreatitis. Immunocytochemical and ultrastructural studies. Virchows Arch [Pathol Anat] 377:157–174Google Scholar
- Moynan RW, Neerhout RC, Johnson TS (1964) Pancreatic carcinoma in childhood. J Pediat 65:711–720Google Scholar
- Mah PT, Loo DC, Tock EPC (1974) Pancreatic acinar cell carcinoma in childhood. Am J Dis Child 128:101–104Google Scholar
- Nanson EM (1954) An unusual case of carcinoma of the head of the pancreas. Br J Surg 41:439–441Google Scholar
- Osborne BM, Culbert SJ, Cangir A, Mackay B (1977) Acinar cell carcinoma of the pancreas in a 9-year-old child: case report with electron microscopic observations. Southern Med J 70:370–372Google Scholar
- Schreiber D, Probst HJ (1977) Sekretorisch aktives Karzinom des exokrinen Pankreas. Fallbericht und Literaturübersicht. Zentralbl Allg Pathol Pathol Anat 121:114–121Google Scholar
- Sternberger LA (1979) Immunocytochemistry, 2nd edn. J Wiley New York — Chichester — Brisbane — TorontoGoogle Scholar
- Taxy JB (1976) Adenocarcinoma of the pancreas in childhood. Report of a case and a review of the English language literature. Cancer 37:1508–1518Google Scholar
- Warren KW (1955) Non-functioning islet cell carcinoma in an 11 year-old child treated by pancreato-duodenectomy. Lahey Clin Bull 9:155–159Google Scholar
- Webb JN (1977) Acinar cell neoplasms of the exocrine pancreas. J Clin Pathol 30:103–112Google Scholar
- Wilander E, Sundström C, Meurling S, Grotte G (1976) A highly differentiated exocrine pancreatic tumour in a young boy. Acta Paediatr Scand 65:769–772Google Scholar
- Wuketich St, Paulik F (1963) Syndrom des metastasierenden lipasebildenden Pankreasadenoms. Zugleich ein Beitrag zur Differentialdiagnose der Pfeifer-Weber-Christianschen Krankheit. Arch Klin Exp Derm 216:412–426Google Scholar