Clinicopathologic study of 62 acinar cell carcinomas of the pancreas: Insights into the morphology and immunophenotype and search for prognostic markers

American Journal of Surgical Pathology

Volumn 36, Issue 12, 2012, Pages 1782-1795

  La Rosa, Stefano ^a   Adsay, Volkan ^b   Albarello, Luca ^c   Asioli, Sofia ^d   Casnedi, Selenia ^e   Franzi, Francesca ^a   Marando, Alessandro ^a   Notohara, Kenji ^f   Sessa, Fausto ^f,g   Vanoli, Alessandro ^h   Zhang, Lizhi ⁱ   Capella, Carlo ^a  

^a UNIVERSITY OF INSUBRIA   (Italy)

^b EMORY UNIVERSITY SCHOOL OF MEDICINE   (United States)

^c SAN RAFFAELE HOSPITAL   (Italy)

^d UNIVERSITY OF TURIN   (Italy)

^e HÔPITAL DE HAUTEPIERRE   (France)

^f KURASHIKI CENTRAL HOSPITAL   (Japan)

^g IRCCS MULTIMEDICA   (Italy)

^h UNIVERSITY OF PAVIA   (Italy)

ⁱ MAYO CLINIC   (United States)

Author keywords

acinar cell carcinoma; morphology; pancreas; prognostic markers

Indexed keywords

TUMOR MARKER;

ACINAR CELL CARCINOMA; ADULT; AGED; ARTICLE; CANCER INVASION; CANCER STAGING; CELL PROLIFERATION; CHEMISTRY; EUROPE; FEMALE; HUMAN; IMMUNOHISTOCHEMISTRY; IMMUNOLOGY; IMMUNOPHENOTYPING; JAPAN; KAPLAN MEIER METHOD; LYMPH NODE METASTASIS; MALE; METASTASIS; MIDDLE AGED; MORTALITY; MULTICENTER STUDY; MULTIVARIATE ANALYSIS; NECROSIS; PANCREAS TUMOR; PATHOLOGY; PREDICTIVE VALUE; PROGNOSIS; PROPORTIONAL HAZARDS MODEL; RISK ASSESSMENT; RISK FACTOR; TUMOR VOLUME; UNITED STATES;

ADULT; AGED; AGED, 80 AND OVER; CARCINOMA, ACINAR CELL; CELL PROLIFERATION; EUROPE; FEMALE; HUMANS; IMMUNOHISTOCHEMISTRY; IMMUNOPHENOTYPING; JAPAN; KAPLAN-MEIER ESTIMATE; LYMPHATIC METASTASIS; MALE; MIDDLE AGED; MULTIVARIATE ANALYSIS; NECROSIS; NEOPLASM INVASIVENESS; NEOPLASM STAGING; PANCREATIC NEOPLASMS; PREDICTIVE VALUE OF TESTS; PROGNOSIS; PROPORTIONAL HAZARDS MODELS; RISK ASSESSMENT; RISK FACTORS; TUMOR BURDEN; TUMOR MARKERS, BIOLOGICAL; UNITED STATES;

EID: 84870058325     PISSN: 01475185     EISSN: 15320979     Source Type: Journal    
DOI: 10.1097/PAS.0b013e318263209d     Document Type: Article

References (45)

1. Klimstra DS. Nonductal neoplasms of the pancreas. Mod Pathol. 2007;20:S94-S112.
2. Hruban RH, Pitman MB, Klimstra DS. Acinar neoplasms. In: Silverberg SG, Sobin LH, eds. Atlas of Tumor Pathology, Series 4. Tumors of the Pancreas. Washington DC: American Registry of Pathology; 1999:191-218.
3. Klimstra DS, Heffess CS, Oertel JE, et al. Acinar cell carcinoma of the pancreas. A clinicopathologic study of 28 cases. Am J Surg Pathol. 1992;16:815-837.
4. Klimstra DS, Hruban RH, Kloppel G, et al. Acinar cell neoplasms of the pancreas. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, eds. WHO Classification of Tumours of the Digestive System. Lyon: IARC Press; 2010:314-318.
5. La Rosa S, Franzi F, Marchet S, et al. The monoclonal anti-BCL10 antibody (clone 331.1) is a sensitive and specific marker of pancreatic acinar cell carcinoma and pancreatic metaplasia. Virchows Arch. 2009;454:133-142.
6. Morohoshi T, Kanda M, Horie A, et al. Immunocytochemical markers of uncommon pancreatic tumors. Acinar cell carcinoma, pancreatoblastoma, and solid cystic (papillary-cystic) tumor. Cancer. 1987;59:739-747.
7. Hoorens A, Lemoine NR, McLellan E, et al. Pancreatic acinar cell carcinoma. An analysis of cell lineage markers, p53 expression, and Ki-ras mutation. Am J Pathol. 1993;143:685-698.
8. Ordonez NG. Pancreatic acinar cell carcinoma. Adv Anat Pathol. 2001;8:144-159.
9. La Rosa S, Klersy C, Uccella S, et al. Improved histologic and clinico-pathologic criteria for prognostic evaluation of pancreatic endocrine tumors. Hum Pathol. 2009;40:30-40.
10. Schmidt CM, Matos JM, Bentrem DJ, et al. Acinar cell carcinoma of the pancreas in the United States: prognostic factors and comparison to ductal adenocarcinoma. J Gastrointest Surg. 2008;12:2078-2086.
11. Wisnoski NC, Townsend CM Jr, Nealon WH, et al. 672 patients with acinar cell carcinoma of the pancreas: a population-based comparison to pancreatic adenocarcinoma. Surgery. 2008;144:141-148.
12. Kitagami H, Kondo S, Hirano S, et al. Acinar cell carcinoma of the pancreas. Clinical analysis of 115 patients from pancreatic cancer registry of Japan pancreas society. Pancreas. 2007;35:42-46.
13. Armstrong MD, Von Hoff D, Barber B, et al. An effective personalized approach to a rare tumor: prolonged survival in metastatic pancreatic acinar cell carcinoma based on genetic analysis and cell line development. J Cancer. 2011;2:142-152.
14. Suzuki A, Sakaguchi T, Morita Y, et al. Long-term survival after a repetitive surgical approach in a patient with acinar cell carcinoma of the pancreas and recurrent liver metastases: report of a case. Surg Today. 2010;40:679-683.
15. Nenutil R, Smardova J, Pavlova S, et al. Discriminating functional and non-functional p53 in human tumours by p53 and MDM2 immunohistochemistry. J Pathol. 2005;207:251-259.
16. Esrig D, Spruck CH III, Nichols PW, et al. p53 nuclear protein accumulation correlates with mutations in the p53 gene, tumor grade, and stage in bladder cancer. Am J Pathol. 1993;143:1389-1397.
17. Tashiro H, Isacson C, Levine R, et al. p53 gene mutation are common in uterine serous carcinoma and occur early in their pathogenesis. Am J Pathol. 1997;150:177-185.
18. Ban D, Shimada K, Sekine S, et al. Pancreatic ducts as an important route of tumor extension for acinar cell carcinoma of the pancreas. Am J Surg Pathol. 2010;34:1025-1036.
19. Toll AD, Mitchell D, Yeo CJ, et al. Acinar cell carcinoma with a prominent intraductal growth pattern: case report with review of the literature. Int J Surg Pathol. 2011;19:795-799.
20. Basturk O, Zamboni G, Klimstra DS, et al. Intraductal and papillary variants of acinar cell carcinomas. A new addition to the challenging differential diagnosis of intraductal neoplasms. Am J Surg Pathol. 2007;31:363-370.
21. Chiou YY, Chiang JH, Hwang JI, et al. Acinar cell carcinoma of the pancreas. Clinical and computed tomography manifestations. J Comput Assist Tomogr. 2004;28:180-186.
22. Hartwig W, Denneberg M, Bergmann F, et al. Acinar cell carcinoma of the pancreas: is resection justified even in limited metastatic disease? Am J Surg. 2011;202:23-27.
23. Holen KD, Klimstra DS, Hummer A, et al. Clinical characteristics and outcomes from an institutional series of acinar cell carcinoma of the pancreas and related tumors. J Clin Oncol. 2002;20:4673-4678.
24. Lee JH, Lee KG, Park HK, et al. Acinar cell carcinoma of the pancreas in Korea. Clinicopathologic analysis of 27 patients from Korean literatures and 2 cases from our hospital. Korean J Gastroenterol. 2010;55:245-251.
25. Lowery MA, Klimstra DS, Shia J, et al. Acinar cell carcinoma of the pancreas: new genetic and treatment insights into a rare malignancy. Oncologist. 2011;16:1714-1720.
26. Mansfield A, Tafur A, Smithedajkul P, et al. Mayo Clinic experience with very rare exocrine pancreatic neoplasms. Pancreas. 2010;39:972-975.
27. Matos JM, Schmidt M, Turrini O, et al. Pancreatic acinar cell carcinoma; a multi-institutional study. J Gastrointest Surg. 2009;13:1495-1502.
28. Ordonez NG, Mackay B. Acinar cell carcinoma of the pancreas. Ultrastruct Pathol. 2000;24:227-241.
29. Seth AK, Argani P, Campbell KA, et al. Acinar cell carcinoma of the pancreas: an institutional series of resected patients and review of the current literature. J Gastrointest Surg. 2008;12:1061-1067.
30. Webb JN. Acinar cell neoplasms of the exocrine pancreas. J Clin Pathol. 1977;30:103-112.
31. Ohike N, Kosmahl M, Kloppel G. Mixed acinar-endocrine carcinoma of the pancreas. A clinicopathological study and comparison with acinar-cell carcinoma. Virchows Arch. 2004;445:231-235.
32. Hruban RH, Pitman MB, Klimstra DS. Adenocarcinoma variants. In: Silverberg SG, Sobin LH, eds. Atlas of Tumor Pathology, Series 4. Tumors of the Pancreas. Washington, DC: American Registry of Pathology; 2007:165-190.
33. Hoorens A, Prenzel K, Lemoine NR, et al. Undifferentiated carcinoma of the pancreas: analysis of intermediate filament profile and Ki-ras mutations provides evidence of a ductal origin. J Pathol. 1998;185:53-60.
34. Notohara K, Hamazaki S, Tsukayama C, et al. Solid-pseudopapil-lary tumor of the pancreas: immunohistochemical localization of neuroendocrine markers and CD10. Am J Surg Pathol. 2000;24:1361-1371.
35. Cao D, Maitra A, Albores Saavedra J, et al. Expression of novel markers of pancreatic ductal adenocarcinoma in pancreatic non-ductal neoplasms: additional evidence of different genetic pathways. Mod Pathol. 2005;18:752-761.
36. La Rosa S, Rigoli E, Uccella S, et al. Prognostic and biological significance of cytokeratin 19 in pancreatic endocrine tumours. Histopathology. 2007;50:597-606.
37. Deshpande V, Fernandez-del Castillo C, Muzikansky A, et al. Cytokeratin 19 is a powerful predictor of survival in pancreatic endocrine tumors. Am J Surg Pathol. 2004;28:1145-1153.
38. Bouwens L. Cytokeratins and cell differentiation in the pancreas. J Pathol. 1998;184:234-239.
39. Abraham SC, Wu TT, Hruban RH, et al. Genetic and immunohis-tochemical analysis of pancreatic acinar cell carcinoma. Frequent allelic loss on chromosome 11p and alterations in the APC/b-catenin pathway. Am J Pathol. 2002;160:953-962.
40. Moore PS, Orlandini S, Zamboni G, et al. Pancreatic tumours: molecular pathways implicated in ductal cancer are involved in ampullary but not in exocrine nonductal or endocrine tumori-genesis. Br J Cancer. 2001;84:253-262.
41. Pellegata NS, Sessa F, Renault B, et al. K-ras and p53 gene mutations in pancreatic cancer: ductal and nonductal tumors progress through different genetic lesions. Cancer Res. 1994;54:1556-1560.
42. de Wilde RF, Ottenhof NA, Jansen M, et al. Analysis of LKB1 mutations and other molecular alterations in pancreatic acinar cell carcinoma. Mod Pathol. 2011;24:1229-1236.
43. Park JY, Hong SM, Klimstra DS, et al. Pdx1 expression in pancreatic precursor lesions and neoplasms. Appl Immunohistochem Mol Morphol. 2011;19:444-449.
44. Butturini G, Pisano M, Scarpa A, et al. Aggressive approach to acinar cell carcinoma of the pancreas: a single-institution experience and a literature review. Langenbecks Arch Surg. 2011;396:363-369.
45. Seket B, Saurin JC, Scoazec JY, et al. Pancreatic acinar cell carcinoma in a patient with familial adenomatous polyposis. Gastroenterol Clin Biol. 2003;27:818-820.