Acinic cell carcinoma of the lung

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.

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.

Primary acinic cell carcinoma of the lung is particularly difficult to diagnose histologically because the primary basis for the diagnosis is morphological features. 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.

When compared to the traditional "blue dot" appearance of acinic cell carcinomas originating from the parotid gland, 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. As a result, PAS-D stain weak positivity or negativity was noted. When assessing pulmonary ACC, immunohistochemical stains are not very useful because they show an immunoprofile that is typical of serous epithelial cells. EMA and cytokeratins typically cause immunoreactivity in these tumors. S100, lysozyme, and chromogranin are all negative. Amylase and α-1-antichymotrypsin have unreliable immunoreactivity.

References

References

1. (2022). "DOG-1 positive primary acinic cell carcinoma of the lung and investigation of molecular status". Pathologica.
2. (1972). "Acinic cell tumor of the lung. A histologic and ultrastructural study". Cancer.
3. (May 2010). "Primary Acinic Cell Carcinoma of the Lung: A Case Report". Lung Cancer.
4. (2019). "Primary Pulmonary Acinic Cell Carcinoma: A Clinicopathological Study of 6 Cases and Literature Review". International Journal of Surgical Pathology.
5. (February 1, 1999). "Acinic Cell Carcinoma of the Lung With Metastasis to Lymph Nodes". Chest.
6. (2012). "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.
7. (2015). "Airway Gland Structure and Function". Physiological Reviews.
8. (November 1992). "Acinic cell carcinoma of the lung ("Fechner tumor"). A clinicopathologic, immunohistochemical, and ultrastructural study of five cases". The American Journal of Surgical Pathology.
9. (2004). "Acinic cell carcinoma: an unusual cause of bronchial obstruction in a child". Pediatric and Developmental Pathology.