Solid and Cystic Acinar Cell Tumor of the Pancreas Isamu Kino 1 , Tomio Arai 1 1The First Department of Pathology, Hamamatsu University School of Medicine pp.767-773
Published Date 1986/7/25
DOI https://doi.org/10.11477/mf.1403110341
  • Abstract
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 A peculiar type of pancreatic tumor has recently been recognized as a clinicopathological entity and termed papillary and solid neoplasm, solid and papillary neoplasm, or solid and cystic acinar cell tumor of the pancreas. In this report, we present two cases of this pancreatic tumor, which were found in one young woman examined because of a large abdominal mass, and in the other during an incidental abdominal examination without detectable functional symptoms. Grossly, the tumors were well circumscribed by a firm, white, fibrous capsule, and their cut surfaces showed mainly cystic degenerative changes with necrotic and hemorrhagic material, with only some solid portions (Fig.2, 3). The solid portions were composed of uniform cells forming solid and pseudopapillary structures with numerous PAS-positive granules (Fig.4, 5). Immunohistochemical staining for alpha-1-antitrypsin showed a granular distribution (Fig.6). Electron microscopic examination showed that the tumor cells had numerous mitochondria and zymogenlike granules (Fig.7). These findings strongly suggested acinar cell differentiation. We regard this as the “major differentiation” in this tumor, although ductal and endocrine differentiation have also been observed by others. Therefore, this type of tumor can best be termed an acinar cell tumor. There was no recurrence in either patient after the operation. The prognosis has been favorable, but reports indicate that this neoplasm should be recognized as a potentially malignant lesion. It seems necessary to accumulate and analyze such cases in detail to clarify the histogenesis and biological behavior of these tumors because this type of tumor is a recently recognized disease which has been under observation for only a short term.

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