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Deb PQ, Suster DI. Outcome of Primary Lung Salivary Gland-Type Carcinoma: A Population-Based Study. Int J Surg Pathol 2024:10668969241256107. [PMID: 38839261 DOI: 10.1177/10668969241256107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
Introduction. Primary pulmonary salivary gland-type carcinomas are rare malignancies arising from minor salivary gland tissue in the lower respiratory tract. Given their rarity, constituting <1% of all primary lung malignancies, their epidemiological features and outcomes remain poorly documented. This study analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database to identify primary pulmonary salivary gland carcinomas, including the most prevalent tumor types. Methods. All patients diagnosed with mucoepidermoid carcinoma, adenoid cystic carcinoma, and epithelial-myoepithelial carcinoma, with the lung designated as the primary site between 1975 and 2019, were subject to analysis. Overall and disease-specific survival were calculated using Kaplan-Meier curves and Cox proportional hazards models. Results. The study identified 323 mucoepidermoid carcinoma, 284 adenoid cystic carcinoma, and 6 epithelial-myoepithelial carcinoma diagnosed as pulmonary salivary gland-type carcinoma. An analysis of age distribution revealed a unimodal pattern for both mucoepidermoid carcinoma and adenoid cystic carcinoma, with most patients diagnosed after age 40. Most patients were Caucasians (77% for mucoepidermoid carcinoma and 83% for adenoid cystic carcinoma). Both disease-specific and overall survival were worse for patients diagnosed at the age of 60 years or above. Race or sex did not significantly impact patient survival. High-grade mucoepidermoid carcinoma demonstrated a significantly worse prognosis than low or intermediate-grade mucoepidermoid carcinoma. Conclusion. A comprehensive review of clinical and epidemiological features of pulmonary salivary gland-type carcinomas reveals that the age of diagnosis and tumor grade are the most significant factors in determining patient survival.
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Affiliation(s)
- Pratik Q Deb
- Department of Pathology, Immunology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA
| | - David I Suster
- Department of Pathology, Immunology & Laboratory Medicine, Rutgers-New Jersey Medical School, Newark, NJ, USA
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Yang MQ, Wang ZQ, Li XF, Chen LQ, Zhang HN, Zhang KX, Xu HT. Primary acinic cell carcinoma of the trachea: A case report and literature review. Medicine (Baltimore) 2023; 102:e32871. [PMID: 36820581 PMCID: PMC9907908 DOI: 10.1097/md.0000000000032871] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
RATIONALE Salivary gland-type acinic cell carcinoma (ACC) is a low-grade malignancy. Primary ACC of the trachea and lungs is rare; here, we describe 1 such case. The histological morphology of tracheal ACC was similar to that of its salivary gland-associated equivalent. Because of its rarity, it is easily misdiagnosed as another type of tracheal or lung tumor. Microscopic analysis of pathological features and immunohistochemistry help diagnose primary ACC of the trachea and lungs. PATIENT CONCERNS A 33-year-old female complained of shortness of breath and hemoptysis for 2 years, and reported the symptoms to have aggravated over the last 4 months. The patient was admitted to our hospital for further treatment. Enhanced computed tomography revealed a soft tissue density nodule shadow in the trachea, which was approximately 1.3 × 1.2 cm in size. DIAGNOSES Based on the clinical information, morphological features, and immunohistochemistry, the pathological diagnosis was primary ACC of the trachea. INTERVENTION The tracheal lesion was resected with an electric snare, electrotomy, freezing, and an argon knife using a rigid bronchoscope. OUTCOMES The patient's postoperative course was uneventful. LESSONS It is important to prevent misdiagnosis of this type of tumor as another type of lung tumor. Morphological and immunohistochemical features can be useful in diagnosing primary ACC of the trachea and lungs.
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Affiliation(s)
- Mai-Qing Yang
- Department of Pathology, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, Shandong Province, China
| | - Zhi-Qiang Wang
- Department of Orthopedics and Trauma, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, Shandong Province, China
| | - Xiu-Feng Li
- Department of Pathology, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, Shandong Province, China
| | - Li-Qian Chen
- Department of Pathology, Weifang People’s Hospital (First Affiliated Hospital of Weifang Medical University), Weifang, Shandong Province, China
| | - Hai-Ning Zhang
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning Province, China
| | - Ke-Xin Zhang
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning Province, China
| | - Hong-Tao Xu
- Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning Province, China
- * Correspondence: Hong-Tao Xu, Department of Pathology, The First Hospital and College of Basic Medical Sciences, China Medical University, Shenyang 110001, China (e-mail: )
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Chen X, Zhang Y, Luo F, Li H. Right pneumonectomy for primary large acinic cell carcinoma (AciCC) with severe mediastinal deviation: a case report and literature review. BMC Surg 2021; 21:368. [PMID: 34663287 PMCID: PMC8522227 DOI: 10.1186/s12893-021-01351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/22/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Primary lung acinic cell carcinoma is very rare. Here we report a young female patient who suffered the largest primary lung acinic cell carcinoma with severe mediastinal deviation which has never been reported before. We also reviewed data and features of 20 previously reported cases of primary lung acinic cell carcinoma who underwent lobectomy. CASE PRESENTATION A 27-year-old female patient presented with recurrent coughing and hemoptysis for more than 10 years came to our hospital. A chest computed tomography (CT) showed a giant space-occupying lesion in the hilum of right lung. After a thorough and detailed preoperative examination, the patient then was performed a radical right pneumonectomy with mediastinal lymph node dissection. The size of the tumor was about 8.6 × 4.5 × 4.4 cm. The pathological results demonstrated a primary acinic cell carcinoma of right lung. The immunohistochemistry of the tumor showed AE1/AE3 (+), Ki-67 (2% +), CK7 (+), Vimentin (+), CK19 (+), α1-ACT (+), AB-PAS (+), S-100 (-), TTF-1 (-). The patient was discharged less than 2 weeks after the operation. So far, the patient has been followed-up for 2 years, and no evidence of tumor recurrence or metastasis was observed. CONCLUSIONS The primary acinic cell carcinoma of lung in this case is the biggest one ever reported and also the first case treated with radical right pneumonectomy. In addition, the patient had a very rare condition of severe mediastinal deviation at the same time. After surgical treatment, the patient recovered uneventfully and had stable disease without recurrence and metastasis after 2 years of follow-up. This case together with the reported case indicate that primary acinic cell carcinoma of lung is of low malignancy, the prognosis and therapy effect of surgical treatment are relatively satisfactory.
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Affiliation(s)
- Xueyu Chen
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 999 Xiwang Road, Jiading District, Shanghai, 201801, People's Republic of China
| | - Yajie Zhang
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 999 Xiwang Road, Jiading District, Shanghai, 201801, People's Republic of China
| | - Fangxiu Luo
- Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 999 Xiwang Road, Jiading District, Shanghai, 201801, People's Republic of China
| | - Hecheng Li
- Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 999 Xiwang Road, Jiading District, Shanghai, 201801, People's Republic of China.
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Watanabe H, Miyagawa‐Hayashino A, Imabayashi T, Kishimoto M, Shimomura M, Honda K, Omatsu I, Shimada E, Inoue M, Takayama K, Konishi E. A rare case of pulmonary typical carcinoid with prominent acinic cell differentiation, resembling acinic cell carcinoma. Pathol Int 2019; 69:721-726. [DOI: 10.1111/pin.12869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/13/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Hiroshi Watanabe
- Departments of Surgical PathologyKyoto Prefectural University of MedicineKyoto Japan
| | | | | | - Mitsuo Kishimoto
- Departments of Surgical PathologyKyoto Prefectural University of MedicineKyoto Japan
| | | | - Kohei Honda
- Departments of Surgical PathologyKyoto Prefectural University of MedicineKyoto Japan
| | - Ikoi Omatsu
- Departments of Surgical PathologyKyoto Prefectural University of MedicineKyoto Japan
| | - Eri Shimada
- Departments of Surgical PathologyKyoto Prefectural University of MedicineKyoto Japan
| | - Masayoshi Inoue
- Thoracic SurgeryKyoto Prefectural University of MedicineKyoto Japan
| | - Koichi Takayama
- Respiratory MedicineKyoto Prefectural University of MedicineKyoto Japan
| | - Eiichi Konishi
- Departments of Surgical PathologyKyoto Prefectural University of MedicineKyoto Japan
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Nie L, Zhou C, Wu H, Zhou Q, Meng F. Primary Pulmonary Acinic Cell Carcinoma: A Clinicopathological Study of 6 Cases and Literature Review. Int J Surg Pathol 2019; 27:584-592. [PMID: 30898020 DOI: 10.1177/1066896919836499] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary pulmonary acinic cell carcinoma (ACC) is rare. The clinicopathological features are not identical to that of classic ACC that leads to misdiagnosis. In this article, we summarized the clinicopathological features of 25 such cases, including 6 cases in this series and additional 19 cases in the literature. Pulmonary ACCs showed an overwhelming solid growth pattern. The neoplastic cells had eosinophilic granular and clear cytoplasm in most cases and displayed basophilic cytoplasm in only 4 cases. Intratumoral fibrous septa, mitotic figure, necrosis, and psammoma bodies were observed in some cases. Prominent nuclear atypia and perineural invasion might suggest high-grade transformation, metastasis, and recurrence. The tumor cells were strongly positive for CK8/18 and negative for TTF-1, p63, S-100, mammaglobin, MUC5b, MUC5ac, and DOG1. CK7 was exclusively positive for neoplastic cells with ductal differentiation. Of the 25 included cases, 10 cases were initially misdiagnosed. The tumor was prone to involve the right bronchus. The patient outcome was favorable. The accurate diagnosis of primary pulmonary ACC relies on comprehensive evaluation of histological and immunohistochemical features and realization of the difference from classic ACC.
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Affiliation(s)
- Ling Nie
- The Affiliated Drum Tower Hospital, Nanjing University, Nanjing, Jiangsu Province, China
| | - Chunlei Zhou
- Children’s Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
| | - Hongyan Wu
- The Affiliated Drum Tower Hospital, Nanjing University, Nanjing, Jiangsu Province, China
| | - Qiang Zhou
- The Affiliated Drum Tower Hospital, Nanjing University, Nanjing, Jiangsu Province, China
| | - Fanqing Meng
- The Affiliated Drum Tower Hospital, Nanjing University, Nanjing, Jiangsu Province, China
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6
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Zhang XP, Jiang GY, Zhang QF, Xu HT, Li QC, Wang EH. Primary acinic cell carcinoma of the lung with psammoma bodies: A case report and review of literature. Pathol Res Pract 2017; 213:405-409. [DOI: 10.1016/j.prp.2017.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 01/14/2017] [Accepted: 01/14/2017] [Indexed: 02/06/2023]
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Elizalde-Torrent A, Fernández-Cortijo J, San José A. [Acinar cell carcinoma of the lung]. Arch Bronconeumol 2010; 46:340-2. [PMID: 20181420 DOI: 10.1016/j.arbres.2009.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2009] [Revised: 12/15/2009] [Accepted: 12/16/2009] [Indexed: 11/30/2022]
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Tavora F, Rassaei N, Shilo K, Foss RD, Galvin JR, Travis WD, Franks TJ. Occult Primary Parotid Gland Acinic Cell Adenocarcinoma Presenting With Extensive Lung Metastasis. Arch Pathol Lab Med 2007; 131:970-3. [PMID: 17550329 DOI: 10.5858/2007-131-970-oppgac] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2006] [Indexed: 11/06/2022]
Abstract
Abstract
Acinic cell adenocarcinoma is a malignant salivary gland neoplasm with a relatively low rate of lymphangitic spread to regional lymph nodes. Distant metastases are rare and their occurrence typically indicates an unfavorable outcome. We encountered an unusual example of acinic cell adenocarcinoma that initially presented in the lung, whereas the primary parotid carcinoma, despite extensive clinical evaluation, only became apparent 1 year after initial diagnosis. The histologic, immunohistochemical, and ultrastructural features of the tumor in the parotid gland and lung were similar. The tumor displayed an aggressive behavior resulting in death within 2 years of the initial presentation. This presentation is unique, showing that peripheral lung tumors of salivary gland type are likely to be metastatic, and careful clinical evaluation is warranted in establishing their primary site of origin.
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Affiliation(s)
- Fabio Tavora
- Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, 6825 16th St NW, Washington, DC 20306, USA
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Watanabe K, Ono N, Hoshi T, Hanzawa M, Ishida T. Fine-needle aspiration cytology of bronchial acinic cell carcinoma: a case report. Diagn Cytopathol 2005; 30:359-61. [PMID: 15108238 DOI: 10.1002/dc.20054] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Salivary gland-type carcinomas of the lung are rare but well-known tumors. Among them, acinic cell carcinoma (ACC) is extremely rare and its cytological features have not been reported. We present a case of bronchial ACC and describe its cytological characteristics. The tumor occurred in a 58-yr-old man as a 15-mm polypoid lesion at the right middle lobar bronchus and filled its lumen. Transbronchial brush cytology and a biopsy failed to collect tumor cells but transbronchial fine-needle aspiration (FNA) cytology was successful. The smear obtained was richly cellular and a large number of thick-layered or monolayered sheet-like tumor cell clusters and dissociated tumor cells were observed. Cribriform globular spaces were common and a lobulated acinar structure was found focally. The tumor cells had a fine granular large polygonal cytoplasm and rather uniform round or ovoid nuclei. The nuclei were situated eccentrically or centrally and the nuclear/cytoplasmic ratio was consistently low. These cytological features were essentially similar to those of ACC of the head and neck region. The patient underwent a lobectomy and the tumor was resected completely. Transbronchial FNA cytology was useful for diagnosing bronchial ACC and differentiating it from other conventional and salivary gland type carcinomas.
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Affiliation(s)
- Kazuo Watanabe
- Pathology Division, Fukushima Medical University School of Medicine Hospital, Fukushima, Japan.
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12
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Sabaratnam RM, Anunathan R, Govender D. Acinic cell carcinoma: an unusual cause of bronchial obstruction in a child. Pediatr Dev Pathol 2004; 7:521-6. [PMID: 15568215 DOI: 10.1007/s10024-004-1014-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Primary acinic cell carcinomas of the lung are rare tumors, usually presenting in adulthood as parenchymal or endobronchial masses. These lesions are generally recognized by their morphological pattern and the presence of periodic acid-Schiff (PAS)-positive, diastase-resistant cytoplasmic granules. We describe a case of pri-mary acinic cell carcinoma of the bronchus in a 4-year-old girl. The tumor has the typical acinar structures:weakly PAS-positive, diastase-resistant cytoplasmic granules and intra-acinar laminated calcific structures. A lobectomy was done with a clear bronchial resection margin. The child is well with no evidence of recurrence or metastasis 2 years postresection.
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MESH Headings
- Airway Obstruction/etiology
- Carcinoma, Acinar Cell/metabolism
- Carcinoma, Acinar Cell/pathology
- Carcinoma, Acinar Cell/surgery
- Carcinoma, Bronchogenic/metabolism
- Carcinoma, Bronchogenic/pathology
- Carcinoma, Bronchogenic/surgery
- Child, Preschool
- Diagnosis, Differential
- Female
- Humans
- Lung/ultrastructure
- Lung Neoplasms/metabolism
- Lung Neoplasms/pathology
- Lung Neoplasms/surgery
- Microscopy, Electron, Transmission
- Periodic Acid-Schiff Reaction
- Secretory Vesicles/ultrastructure
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Affiliation(s)
- Rathi M Sabaratnam
- Department of Anatomical Pathology, Neson R. Mandela School of Medicine, University of KwaZulu-Natal, Congella, Durban, South Africa
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Abstract
Salivary-type tumors occur in multiple sites in the human body, likely related to a basic structural homology between exocrine glands in these different anatomic areas. This paper reviews these salivary gland tumor types in breast tissue and lung. Salivary-type tumors of both breast and lung are relatively uncommon in comparison to their salivary gland counterparts. This may be attributable in part to lack of familiarity with these tumors in extra-salivary sites, and in part to histologic overlap with other primary and metastatic tumor types. Recognition of these entities is improving as the clinical and pathologic features are better delineated, and tumors are more accurately classified. Prediction of malignant behavior is not always possible in these unusual sites. In some instances, such as adenoid cystic carcinoma, behavior is known to differ considerably from that of analogous primary salivary gland tumors and in other instances there are simply too few reported cases to allow for adequate prognostication. In fact, more recent papers discuss the need to consider a spectrum encompassing benign and malignant lesions, in both breast and lung. Of course, some entities show clear-cut evidence of malignancy with documented potential for metastasis, others show bland features and well-reported benign behavior, and the less well-defined entities reside between these two extremes. The molecular pathology of salivary gland tumors has been reasonably well investigated in that location; however; there are few molecular studies devoted to salivary-type tumors of the breast and lung. This represents a potential area for future growth in further clarifying these tumors and their behavior.
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Affiliation(s)
- Audrey K Bennett
- Robert E. Fecuhner Division of Surgical Pathology, Department of Pathology, University of Virginia Medical Center, Charlottesville, VA 22908, USA
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