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Case 457 - Discussion

Uploaded: 2010-11-22, Updated: 2010-11-22


Acinic Cell Carcinoma of Parotid Gland

  • 1-3% of salivary gland tumors; #2 childhood salivary gland malignancy after mucoepidermoid carcinoma

  • Histopathology:

    • Variable patterns: solid, microcystic, papillary cystic, follicular

    • Variable cell types:

      • Acinar (serous) cell type: large, round to polygonal cells, basophilic granular cytoplasm, round eccentric nuclei

      • Clear cells type: hypernephroid pattern, contains glycogen or mucin

      • Vacuolated type: small clear cytoplasmic vacuoles

      • Intercalated duct: cuboidal cells with round central nuclei, variable small cystic/luminal spaces containing pale-staining proteinaceous material

      • Nonspecific glandular cells (smaller, syncytial)

    • Few mitotic figures, may have prominent lymphoid follicles at periphery (lymphoid stroma), psammoma bodies

  • Positive: keratin, alpha-1-antichymotrypsin, alpha amylase, vasoactive intestinal polypeptide, myoepithelial markers,

    granules PAS+ diastase resistant

  • 10-15% metastasize, 10-30% recur; 5 year survival 90%, 20 year survival 60%

  • Less aggressive in minor salivary glands