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{{Infobox medical condition (new)
{{Infobox medical condition (new)
| name = <!--{{PAGENAME}} by default-->
| name = Acinic cell carcinoma of the lung
| synonym =
| synonym = Fechner tumor, AcCC of the lung
| image =
| image = Acinic cell carcinoma - high mag.jpg
| image_size =
| image_size =
| alt =
| alt =
| caption = Very high magnification [[micrograph]] of an [[acinic cell carcinoma]], abbreviated AcCC. [[H&E stain]].
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| caption =
| pronounce =
| pronounce =
| specialty = oncology
| specialty = [[Oncology]], [[Pulmonology]]
| symptoms =
| symptoms =
| complications =
| complications =
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| deaths =
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}}
}}
'''Acinic cell carcinoma of the lung''' is a very uncommon tumor that typically appears close to the right [[bronchus]].<ref name="DOG-1 positive">{{cite journal | last=Nibid | first=Lorenzo | last2=Frasca | first2=Luca | last3=Sabarese | first3=Giovanna | last4=Righi | first4=Daniela | last5=Taccogna | first5=Silvia | last6=Crucitti | first6=Pierfilippo | last7=Graziano | first7=Paolo | last8=Perrone | first8=Giuseppe | title=DOG-1 positive primary acinic cell carcinoma of the lung and investigation of molecular status | journal=Pathologica | publisher=Pacini Editore | volume=114 | issue=5 | pmid=36305026 | doi=10.32074/1591-951X-786 |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9614299/ | access-date=December 28, 2023 | doi-access=free}}</ref> As of 2022, only 29 cases have been documented in the English literature<ref name="DOG-1 positive"/> since Fechner et al. first described this entity in 1972.<ref name="Fechner">{{cite journal | last=RE | first=Fechner | last2=BR | first2=Bentinck | last3=JB | first3=Askew | title=Acinic cell tumor of the lung. A histologic and ultrastructural study | journal=Cancer | publisher=Cancer | volume=29 | issue=2 | issn=0008-543X | pmid=4111143 | doi=10.1002/1097-0142(197202)29:2&lt;501::aid-cncr2820290241&gt;3.0.co;2-b |url=https://pubmed.ncbi.nlm.nih.gov/4111143/ | access-date=December 28, 2023 | page=}}</ref> Histologically similar to the major and minor [[Salivary gland|salivary glands]], [[pluripotent]] cells of the [[Submucosal glands|submucosal]] serous and mucous glands of the [[tracheobronchial tree]] are thought to be the source of acinic cell carcinoma of the lung. The histologic characteristics of acinic cell carcinoma of the lung are nearly identical to those of the [[Salivary gland|salivary glands]].<ref name="A Case Report">{{cite journal |last1=Cho |first1=Junhun |last2=Kim |first2=Taeeun |last3=Han |first3=Joungho |last4=Kim |first4=Kwhanmien |last5=Kim |first5=Tae Sung |title=Primary Acinic Cell Carcinoma of the Lung: A Case Report |journal=Lung Cancer |date=May 2010 |volume=9 |issue=1 |pages=20-23 |url=https://synapse.koreamed.org/upload/synapsedata/pdfdata/0160jlc/jlc-9-20.pdf |access-date=28 December 2023}}</ref>
'''Acinic cell carcinoma of the lung''' is a very rare [[malignant]] [[neoplasm]] originating from bronchial glands.<ref name='ChuahYap'>Chuah KL, Yap WM, Tan HW, Koong HN. Recurrence of pulmonary acinic cell carcinoma. ''Arch Pathol Lab Med'' 2006;130:932-3.</ref> It is classified as a salivary gland-like carcinoma under the most widely used lung cancer classification system.<ref name='who2004'>{{cite book |title=Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart |editor1-last=Travis |editor1-first=William D |editor2-last=Brambilla |editor2-first=Elisabeth |editor3-last=Muller-Hermelink |editor3-first=H Konrad |editor4-last=Harris |editor4-first=Curtis C |publisher=IARC Press |location=Lyon |year=2004 |series=World Health Organization Classification of Tumours |isbn=92-832-2418-3 |url=http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/bb10-cover.pdf |accessdate=27 March 2010 |archive-url=https://web.archive.org/web/20090823210304/http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/bb10-cover.pdf |archive-date=2009-08-23 |url-status=dead }}</ref>


== References ==
==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]].<ref name="Study of 6 Cases and Literature Review">{{cite journal | last=Nie | first=Ling | last2=Zhou | first2=Chunlei | last3=Wu | first3=Hongyan | last4=Zhou | first4=Qiang | last5=Meng | first5=Fanqing | title=Primary Pulmonary Acinic Cell Carcinoma: A Clinicopathological Study of 6 Cases and Literature Review | journal=International Journal of Surgical Pathology | volume=27 | issue=6 | date=2019 | issn=1066-8969 | doi=10.1177/1066896919836499 | pages=584–592}}</ref>

==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.<ref name="Elsevier 1999 pp. 591–595">{{cite journal | title=Acinic Cell Carcinoma of the Lung With Metastasis to Lymph Nodes | journal=Chest | publisher=Elsevier | volume=115 | issue=2 | date=February 1, 1999 | issn=0012-3692 | doi=10.1378/chest.115.2.591 | pages=591–595 |url=https://www.sciencedirect.com/science/article/pii/S0012369215506132 | access-date=December 28, 2023}}</ref>

Primary acinic cell carcinoma of the lung is particularly difficult to diagnose histologically because the primary basis for the diagnosis is morphological features.<ref name="DOG-1 positive"/> 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.<ref name="Fechner"/>

When compared to the traditional "blue dot" appearance of [[Acinic cell carcinoma|acinic cell carcinomas]] originating from the [[parotid gland]],<ref name="S J M T p. ">{{cite journal | last=S | first=Schwarz | last2=J | first2=Zenk | last3=M | first3=Müller | last4=T | first4=Ettl | last5=PH | first5=Wünsch | last6=A | first6=Hartmann | last7=A | first7=Agaimy | title=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 | journal=Histopathology | publisher=Histopathology | volume=61 | issue=3 | issn=1365-2559 | pmid=22551398 | doi=10.1111/j.1365-2559.2012.04233.x |url=https://pubmed.ncbi.nlm.nih.gov/22551398/ | access-date=December 28, 2023 | page=}}</ref> 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 [[Peptide|peptides]], proteins, and small organic molecules acting as [[Antimicrobial|antimicrobials]], as well as the fact that they do not produce digestive [[zymogen]].<ref name="JH JJ p. ">{{cite journal | last=JH | first=Widdicombe | last2=JJ | first2=Wine | title=Airway Gland Structure and Function | journal=Physiological reviews | publisher=Physiol Rev | volume=95 | issue=4 | issn=1522-1210 | pmid=26336032 | doi=10.1152/physrev.00039.2014 |url=https://pubmed.ncbi.nlm.nih.gov/26336032/ | access-date=December 28, 2023 | doi-access=free}}</ref> As a result, [[PASD stain|PAS-D stain]] weak positivity or negativity was noted.<ref name="CA S MN p. ">{{cite journal | last=CA | first=Moran | last2=S | first2=Suster | last3=MN | first3=Koss | title=Acinic cell carcinoma of the lung ("Fechner tumor"). A clinicopathologic, immunohistochemical, and ultrastructural study of five cases | journal=The American journal of surgical pathology | publisher=Am J Surg Pathol | volume=16 | issue=11 | issn=0147-5185 | pmid=1471724 | doi=10.1097/00000478-199211000-00002 |url=https://pubmed.ncbi.nlm.nih.gov/1471724/ | access-date=December 28, 2023 | page=}}</ref><ref name="unusual cause of bronchial obstruction">{{cite journal | last=RM | first=Sabaratnam | last2=R | first2=Anunathan | last3=D | first3=Govender | title=Acinic cell carcinoma: an unusual cause of bronchial obstruction in a child | journal=Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society | publisher=Pediatr Dev Pathol | volume=7 | issue=5 | issn=1093-5266 | pmid=15568215 | doi=10.1007/s10024-004-1014-z |url=https://pubmed.ncbi.nlm.nih.gov/15568215/ | access-date=December 28, 2023 | page=}}</ref> When assessing pulmonary ACC, [[Immunohistochemistry|immunohistochemical]] stains are not very useful because they show an immunoprofile that is typical of serous [[epithelial cells]].<ref name="unusual cause of bronchial obstruction"/> EMA and [[Cytokeratin|cytokeratins]] typically cause immunoreactivity in these tumors. [[S100 protein|S100]], [[lysozyme]], and [[chromogranin]] are all negative.<ref name="unusual cause of bronchial obstruction"/><ref name="CA S MN p. "/> [[Amylase]] and α-1-antichymotrypsin have unreliable immunoreactivity.<ref name="Study of 6 Cases and Literature Review"/>

==See also==
* [[Acinic cell carcinoma]]
⚫
* [[Lung cancer]]

==References==
{{Reflist}}
{{Reflist}}


==Further reading==
⚫
== External links ==
* {{cite journal | last=Chen | first=Xueyu | last2=Zhang | first2=Yajie | last3=Luo | first3=Fangxiu | last4=Li | first4=Hecheng | title=Right pneumonectomy for primary large acinic cell carcinoma (AciCC) with severe mediastinal deviation: a case report and literature review | journal=BMC Surgery | volume=21 | issue=1 | date=2021 | issn=1471-2482 | pmid=34663287 | pmc=8522227 | doi=10.1186/s12893-021-01351-8 | ref=none | doi-access=free}}
* {{cite journal | last=HY | first=Lee | last2=K | first2=Mancer | last3=HN | first3=Koong | title=Primary acinic cell carcinoma of the lung with lymph node metastasis | journal=Archives of pathology &amp; laboratory medicine | publisher=Arch Pathol Lab Med | volume=127 | issue=4 | issn=1543-2165 | pmid=12683906 | doi=10.5858/2003-127-e216-PACCOT |url=https://pubmed.ncbi.nlm.nih.gov/12683906/ | access-date=December 28, 2023 | doi-access=free | ref=none}}

⚫
==External links==
* [http://www.cancer.gov/cancertopics/types/lung Lung Cancer Home Page] The [[National Cancer Institute]] site containing further reading and resources about lung cancer.
* [http://www.cancer.gov/cancertopics/types/lung Lung Cancer Home Page] The [[National Cancer Institute]] site containing further reading and resources about lung cancer.
* [https://web.archive.org/web/20110721001056/http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/BB10.pdf World Health Organization Histological Classification of Lung and Pleural Tumours. 4th Edition.]
* [https://web.archive.org/web/20110721001056/http://www.iarc.fr/en/publications/pdfs-online/pat-gen/bb10/BB10.pdf World Health Organization Histological Classification of Lung and Pleural Tumours. 4th Edition.]


{{Medical resources
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[[Category:Lung cancer]]
| ICD11 = {{ICD11|2C25}}
| ICD10 = {{ICD10|C34}}
| ICD10CM = <!-- {{ICD10CM|Xxx.xxxx}} -->
| ICD9 = {{ICD9|162.9}}
| ICDO =
| OMIM =
| MeshID =
| DiseasesDB =
| SNOMED CT =
| Curlie =
| MedlinePlus =
| eMedicineSubj =
| eMedicineTopic =
| PatientUK =
| NCI =
| GeneReviewsNBK =
| GeneReviewsName =
| NORD =
| GARDNum =
| GARDName =
| RP = 36525
| AO =
| WO =
| OrthoInfo =
| Orphanet =
| Scholia = Q4674171
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| OB =
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[[Category:Lung cancer]]

{{Respiratory-disease-stub}}
{{Oncology-stub}}

Revision as of 21:54, 28 December 2023

Acinic cell carcinoma of the lung
Other namesFechner tumor, AcCC of the lung
Very high magnification micrograph of an acinic cell carcinoma, abbreviated AcCC. H&E stain.
SpecialtyOncology, Pulmonology

Acinic cell carcinoma of the lung is a very uncommon tumor that typically appears close to the right bronchus.[1] As of 2022, only 29 cases have been documented in the English literature[1] since Fechner et al. first described this entity in 1972.[2] Histologically similar to the major and minor salivary glands, pluripotent cells of the submucosal serous and mucous glands of the tracheobronchial tree are thought to be the source of acinic cell carcinoma of the lung. The histologic characteristics of acinic cell carcinoma of the lung are nearly identical to those of the salivary glands.[3]

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.[4]

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.[5]

Primary acinic cell carcinoma of the lung is particularly difficult to diagnose histologically because the primary basis for the diagnosis is morphological features.[1] 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.[2]

When compared to the traditional "blue dot" appearance of acinic cell carcinomas originating from the parotid gland,[6] 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.[7] As a result, PAS-D stain weak positivity or negativity was noted.[8][9] When assessing pulmonary ACC, immunohistochemical stains are not very useful because they show an immunoprofile that is typical of serous epithelial cells.[9] EMA and cytokeratins typically cause immunoreactivity in these tumors. S100, lysozyme, and chromogranin are all negative.[9][8] Amylase and α-1-antichymotrypsin have unreliable immunoreactivity.[4]

See also

References

  1. ^ a b c Nibid, Lorenzo; Frasca, Luca; Sabarese, Giovanna; Righi, Daniela; Taccogna, Silvia; Crucitti, Pierfilippo; Graziano, Paolo; Perrone, Giuseppe. "DOG-1 positive primary acinic cell carcinoma of the lung and investigation of molecular status". Pathologica. 114 (5). Pacini Editore. doi:10.32074/1591-951X-786. PMID 36305026. Retrieved December 28, 2023.
  2. ^ a b RE, Fechner; BR, Bentinck; JB, Askew. "Acinic cell tumor of the lung. A histologic and ultrastructural study". Cancer. 29 (2). Cancer. doi:10.1002/1097-0142(197202)29:2&lt;501::aid-cncr2820290241&gt;3.0.co;2-b. ISSN 0008-543X. PMID 4111143. Retrieved December 28, 2023.
  3. ^ Cho, Junhun; Kim, Taeeun; Han, Joungho; Kim, Kwhanmien; Kim, Tae Sung (May 2010). "Primary Acinic Cell Carcinoma of the Lung: A Case Report" (PDF). Lung Cancer. 9 (1): 20–23. Retrieved 28 December 2023.
  4. ^ a b Nie, Ling; Zhou, Chunlei; Wu, Hongyan; Zhou, Qiang; Meng, Fanqing (2019). "Primary Pulmonary Acinic Cell Carcinoma: A Clinicopathological Study of 6 Cases and Literature Review". International Journal of Surgical Pathology. 27 (6): 584–592. doi:10.1177/1066896919836499. ISSN 1066-8969.
  5. ^ "Acinic Cell Carcinoma of the Lung With Metastasis to Lymph Nodes". Chest. 115 (2). Elsevier: 591–595. February 1, 1999. doi:10.1378/chest.115.2.591. ISSN 0012-3692. Retrieved December 28, 2023.
  6. ^ S, Schwarz; J, Zenk; M, Müller; T, Ettl; PH, Wünsch; A, Hartmann; A, Agaimy. "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. 61 (3). Histopathology. doi:10.1111/j.1365-2559.2012.04233.x. ISSN 1365-2559. PMID 22551398. Retrieved December 28, 2023.
  7. ^ JH, Widdicombe; JJ, Wine. "Airway Gland Structure and Function". Physiological reviews. 95 (4). Physiol Rev. doi:10.1152/physrev.00039.2014. ISSN 1522-1210. PMID 26336032. Retrieved December 28, 2023.
  8. ^ a b CA, Moran; S, Suster; MN, Koss. "Acinic cell carcinoma of the lung ("Fechner tumor"). A clinicopathologic, immunohistochemical, and ultrastructural study of five cases". The American journal of surgical pathology. 16 (11). Am J Surg Pathol. doi:10.1097/00000478-199211000-00002. ISSN 0147-5185. PMID 1471724. Retrieved December 28, 2023.
  9. ^ a b c RM, Sabaratnam; R, Anunathan; D, Govender. "Acinic cell carcinoma: an unusual cause of bronchial obstruction in a child". Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society. 7 (5). Pediatr Dev Pathol. doi:10.1007/s10024-004-1014-z. ISSN 1093-5266. PMID 15568215. Retrieved December 28, 2023.

Further reading

External links

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