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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
Author(s) -
Schwarz Stephan,
Zenk Johannes,
Müller Maximilian,
Ettl Tobias,
Wünsch Peter H,
Hartmann Arndt,
Agaimy Abbas
Publication year - 2012
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/j.1365-2559.2012.04233.x
Subject(s) - acinic cell carcinoma , pathology , immunohistochemistry , eosinophilic , cytokeratin , biology , staining , salivary gland , histopathology , keratin , acinar cell , medicine , mucoepidermoid carcinoma , endocrinology , pancreas
Schwarz S, Zenk J, Müller M, Ettl T, Wünsch P H, Hartmann A & Agaimy A
(2012) Histopathology 61, 395–408 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 Aims: To study the morphological heterogeneity of acinic cell carcinoma (ACC) in correlation with clinicopathological parameters. Methods and results: Forty well‐characterized ACCs were classified as solid ( n = 20), microcystic ( n = 15), papillary‐cystic ( n = 4) or follicular ( n = 1), based on the dominant architectural growth pattern. Fourteen tumours exhibited eosinophilic/clear cell morphology and 18 tumours were rich in zymogen granules (so‐called blue dot tumours). High‐grade morphology occurred in five tumours. Based on cytokeratin (CK) 7 staining and in analogy to CK7 expression in normal salivary gland epithelia, three distinct histogenetic subtypes were recognized: acinar (CK7‐negative; n = 13), ductular (diffuse CK7‐positive; n = 11) and mixed ductulo‐acinar (10–66% CK7‐positive cells; n = 16). Most papillary‐cystic tumours displayed ductular differentiation ( P = 0.015), whereas blue dot tumours never did ( P < 0.001). Analysis of relapse‐free survival (RFS) revealed that Stage I tumours had the best prognosis without any relapse in 18 years follow‐up ( P = 0.06). High‐grade tumours were associated with shorter RFS ( P = 0.028). Concerning the histogenetic types, monophasic (pure acinar or ductular) tumours were associated with a significantly better RFS than mixed ductulo‐acinar tumours ( P = 0.008). Conclusion: The results underscore the great histological diversity of ACC, and the value of histogenetic subtyping as an additional prognostic factor regarding RFS.