Acinic cell carcinoma of the lung explained

Acinic cell carcinoma of the lung
Synonym:Fechner tumor, AcCC of the lung
Specialty:Oncology, 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

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

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

Further reading

External links

Notes and References

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

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