J Lung Cancer.  2010 Jun;9(1):20-23. 10.6058/jlc.2010.9.1.20.

Primary Acinic Cell Carcinoma of the Lung: A Case Report

Affiliations
  • 1Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hanjho@skku.edu
  • 2Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 3Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

Primary acinic cell carcinoma (ACC) of the lung is very rare and this tumor is thought to arise from pluripotent cells of the submucosal glands of the tracheobronchial tree. We report here on a case of primary ACC of the lung in a 68-year-old man who had a solitary pulmonary nodule in the left lower lobe. The patient was symptomless and the lesion was found on a chest X-ray taken during a regular health checkup. The video assisted thoracoscopic surgery wedge resection revealed an ovoid yellow tan solid mass that was 1.8 cm at the largest diameter. Microscopically, the neoplastic cells grew in solid sheets of round cells with eccentric nuclei and abundant basophilic granular cytoplasm. There were no mitotic figures or areas of pleomorphic or anaplastic cells. Immunohistochemical staining for cytokeratin (AE1/AE3) was positive, but the staining for chromogranin A and CD56 was negative. Ultrastructural examination revealed polyhedral cells with many zymogen granules of varying electron density. The patient is well 4 months postoperatively.

Keyword

Acinar cell carcinoma; Lung neoplasms; Solitary pulmonary nodule

MeSH Terms

Acinar Cells
Aged
Basophils
Carcinoma, Acinar Cell
Chromogranin A
Cytoplasm
Electrons
Humans
Keratins
Lung
Lung Neoplasms
Secretory Vesicles
Solitary Pulmonary Nodule
Thoracic Surgery, Video-Assisted
Thorax
Triacetoneamine-N-Oxyl
Chromogranin A
Keratins
Triacetoneamine-N-Oxyl

Figure

  • Fig. 1. (A) The chest PA X-ray and CT show an ovoid pulmonary nodule (1.3 cm, arrows) in the left lower lobe of lung. (B) On the VATS wedge resection, the cut surface of the lung shows a well demarcated round yellow tan solid mass without necrosis or hemorrhage. (C) The tumor has a fibrous pseudocapsule and it is composed of sheets of round or ovoid uniform cells with a peripheral microcystic pattern (H&E stain, ×50). (D) The tumor cells have eosinophilic or basophilic granular cytoplasm with round to oval nuclei (H&E stain, ×400). (E) On ultrastructural examination of the formalin-fixed, paraffin-embedded tissue, the cytoplasm of the tumor cells has many well-developed organelles, including many mitochondria, endoplasmic reticulum, ribosomes and glycogen granules. Several membrane bounded electron dense secretory granules are also identified.


Reference

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