Pancreatic endocrine tumor with partial acinar cell differentiation

• Published in: APMIS : acta pathologica, microbiologica et immunologica Scandinavica Vol. 114; no. 10; pp. 720 - 725
• Main Authors: MINAKAWA, KYOKO, OKA, KUNIYUKI, NIHEI, TAKESHI, SANDO, NORIMASA, OIKAWA, HARUNA, TODA, JOE, HOSOKAWA, YOSHINORI, MATSUMOTO, TOSHIHARU, YANAGISAWA, AKIO
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.10.2006
• Subjects: acinar cell differentiation; Aged; alpha 1-Antitrypsin - analysis; alpha 1-Antitrypsin - metabolism; Biomarkers, Tumor - analysis; Biomarkers, Tumor - metabolism; Biopsy, Needle; Carcinoma, Acinar Cell - diagnosis; Carcinoma, Acinar Cell - metabolism; Carcinoma, Acinar Cell - pathology; Carcinoma, Islet Cell - diagnosis; Carcinoma, Islet Cell - metabolism; Carcinoma, Islet Cell - pathology; Cytoplasmic Granules - ultrastructure; electron microscopy; Female; Humans; Immunohistochemistry; Neoplasms, Multiple Primary - diagnosis; Neoplasms, Multiple Primary - metabolism; Neoplasms, Multiple Primary - pathology; neuroendocrine granule; Pancreas - metabolism; Pancreas - pathology; Pancreatic endocrine tumor; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - metabolism; Pancreatic Neoplasms - pathology; Secretory Vesicles - ultrastructure; Synaptophysin - analysis; Synaptophysin - metabolism; Ultrasonography; zymogen granule
• ISSN: 0903-4641; 1600-0463
• DOI: 10.1111/j.1600-0463.2006.apm_407.x

We examined a 70‐year‐old woman in whom a pancreatic endocrine tumor with partial acinar cell differentiation had been diagnosed. She had neither endocrine nor exocrine symptoms. The tumor was located in the pancreatic tail and measured 12.5×9.5×8 cm. It had a capsule, was composed of multiple adhesion nodules, and was elastically soft, medullary, and yellowish white. The neoplastic cells had large, irregular, oval nuclei; prominent eosinophilic nucleoli; and abundant eosinophilic cytoplasm with many fine granules. The cells had proliferated in islet‐like solid medullary, trabecular, acinar, and papillary patterns. Most neoplastic cells were strongly positive for synaptophysin. 10 to 25% of the neoplastic cells were positive for α1‐antitrypsin. Neuroendocrine and zymogen granules were simultaneously observed in the cytoplasm of the same neoplastic cells at the ultrastructural level. The tumor may be considered an amphicrine tumor.