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RESIDENT
CASE
STUDIES
Week 11 June 28 - July 4, 2003: Case
2
Table
of Contents
| List of Diagnoses | Case 1 |
Case 2
| Case 3
46
year old male with left parotid mass Discussion
Acinic cell carcinoma largely occurs in the salivary gland, but may occur
in the submandibular or minor salivary glands. It is more common in women
and occurs in adults mostly around the 5th and 6th
decades of life. It is not a very common salivary gland tumor. Microscopically,
the tumor cells have a fine granular cytoplasm (consisting of zymogen
granules) and resemble serous cellular elements of the normal parotid
gland at both the light and ultrastructural levels.1 The
intercalated ducts may be present.2 However, in addition to the
classic serous cells, the lesional tissue may be composed of clear cells.2
There are other histologic variants of this neoplasm – microcystic,
follicular and papillary-cystic – all of which have the typical acinar
cells, even if infrequent.2 According to Lewis et al. neither
the degree of acinar differentiation nor the various growth patterns in
acinic cell carcinomas appear to influence prognosis.3 The
zymogen granules of acinic cell carcinoma are PAS positive, while
cytokeratin may highlight the intercalated ducts. References:
1Dardick I,
George D, Jeans MTD, et al. Ultrastructural morphology and cellular
diffentiation in acinic cell carcinoma. Oral Surg Oral Med Oral Pathol
1987;63:325-334.
2Irving, D.
Color Atlas/Text of salivary Gland Tumor Pathology 1996 (1st
ed).Igaku-Shoin Medical Publishers.
3Lewis
JE, Olsen KD, Weiland LH. Acinic cell carcinoma: Clinicopathologic review.
Cancer 1991;67:172-179.
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