Acinar cell carcinoma of the pancreas

Acinar cell carcinoma of the pancreas, also acinar cell carcinoma, is a rare malignant exocrine tumour of the pancreas. It represents 5% of all exocrine tumours of the pancreas, making it the second most common type of pancreatic cancer. It is abbreviated ACC. It typically has a guarded prognosis.

Symptoms

CT scan in a patient with acinar cell carcinoma

The disease is more common in men than women and the average age at diagnosis is about 60. Symptoms are often non-specific and include weight loss. A classic presentation, found in around 15% of cases includes subcutaneous nodules (due to fat necrosis) and arthralgias, caused by release of lipase.

Pathology

ACC are associated with increased serum lipase and manifest in the classic presentation as the Schmid triad (subcutaneous fat necrosis, polyarthritis, eosinophilia).

ACC are typically large, up to 10cm, and soft compared to pancreatic adenocarcinoma, lacking its dense stroma. They can arise in any part of the pancreas.

Histomorphologically, the tumour resembles the cells of the pancreatic acini and, typically, have moderate granular cytoplasm that stain with both PAS and PASD.

Treatment

ACC can be treated with a Whipple procedure.

See also

• Pancreatic cancer

References

• "Von Hoff": Daniel D. Von Hoff, Douglas Brian Evans, Ralph H. Hruban, eds. Pancreatic Cancer, 2005, Jones & Bartlett Learning, ISBN 0763721786, 9780763721787

External links

• Acinar cell carcinoma of the pancreas (harvard.edu)

• Tobias Jeffrey S., Hochhauser, Daniel, Cancer and its Management, p. 276, 2010 (6th edn), ISBN 1118713257, 9781118713259
• Von Hoff, 23
• Von Hoff, 23
• Von Hoff, 23