Pure acinic cell carcinoma of the breast in an 80-year-old Japanese woman

ArticleinPathology International 57(1):43-6 · February 2007with14 Reads
DOI: 10.1111/j.1440-1827.2007.02055.x · Source: PubMed
Abstract
Acinic cell carcinoma of the breast is an uncommon neoplasm. Since the first case of this rare variant of breast carcinoma was reported in 1996, only 10 cases have been reported in the English-language literature. Reported herein is the first case of primary acinic cell carcinoma of the breast in a Japanese woman. To the naked eye, the tumor appeared well circumscribed and the cut surface was grayish-pink and hemorrhaging. Microscopically, the tumor was predominantly made up of a monotonous proliferation of cells with a finely granular cytoplasm, resembling acinic cells of the parotid gland. Some neoplastic cells had a clear cytoplasm. In spite of extensive sampling, no common histological patterns of breast carcinoma such as in situ and invasive ductal carcinoma were recognized in the present case, indicating that the present case was pure acinic cell carcinoma. In addition, the immunohistochemical profile of this tumor was identical to that of the acinic cell carcinoma of the salivary gland: estrogen receptor, progesterone receptor, HER2 and cytokeratin (CK)20 were negative and amylase and CK7 were positive. The patient has been well for 22 months since the wide local excision of the tumor and no signs of salivary neoplasm are evident to date.
    • "A common " triple negativity " for ER, PR and Her2/neu should suggest the possibility of a breast cancer a quite different from ordinary, such as salivary gland-like tumors [34]. The cases reviewed showed sometimes uncommon negativity for lysozyme, for amylase, for S-100 [5,12,18,20]. Otherwise in some cases strange positivity for ER, PR or AR could confound the diagnosis . Positivity to GCDFP15 could suggest an apocrine differentiation associated to ACC. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction: The breast and salivary gland tissue share embryologic and thus pathological similarities. Acinic cell carcinoma (ACC) is a typical tumor in salivary glands, but rarely arises in breast too. We reviewed 38 cases of mammary ACC reported in literature and our case, the first ACC born within a fibroadenoma. Materials and methods: Data were collected by a research for the key words acinic cell carcinoma breast on Pubmed in March 2014, including a case treated in our department. All reviewed cases were compared for clinical approach and histological pattern. Results: To date 23 articles presenting cases of ACC of the breast are reported in literature. We included in our review 38 cases previously described and one new case. The histological pattern was predominantly solid with a microglandular structure. All the tumor cells were cytologically characterized by monotonous round cells with a finely granular, weakly eosinophilic, or clearly vacuolated cytoplasm. The most of the cells were intensely stained with anti-lysozime, anti-amylase, anti-α1-chimotripsin, anti-EMA and anti-S100 protein antisera. Immunohistochemistry was also performed to point out: estrogen receptor (ER), progesterone receptor (PR), androgen receptors (AR), human epidermal growth factor receptor 2 overexpression (HER2/neu), E-cadherin (E-cad), cytokeratin-7 (CK7), gross cystic disease fluid protein 15 (GCDFP15), smooth muscle actin (SMA). Conclusion: ACC of the breast is a rare tumor, showing similarities with the salivary gland counterpart, above all in terms of good prognosis, and differences from the ordinary invasive breast carcinoma. Further investigations are needed to elucidate the true histogenesis and the correct treatment.
    Full-text · Article · May 2014
    • "ACC is a malignant tumor showing acinar cell differentiation with typical morphological and immunohistochemical findings and it was first described by Roncaroli et al. in 1996 [1]. To the best of our knowledge hitherto only 26 cases of ACC have been reported in the English literature [1,456789101112131415161718, among these we found only one case describing ACC arising in a MGA background [9]. Primary ACC of the breast presents in women between 35 and 80 years of age as a palpable lump, with the right side being more commonly affected. "
    [Show abstract] [Hide abstract] ABSTRACT: Acinic cell carcinoma is a rare breast tumour belonging to salivary gland-like tumours of the breast. They are "triple-negative" breast cancers even if their biological behaviour seems to be more favourable. Herein we present an acinic cell carcinoma arising on a background of typical and atypical microglandular adenosis in a 58-year-old woman, along with a review of the literature.
    Full-text · Article · Nov 2013
    • "Several studies have discussed the usefulness of diagnostic imagings for ACC, although their findings have sometimes differed [1, 2,8910. For example, mammography showed a well-defined mass in some cases [1, 8, 10] but no abnormal findings in another [9]. Ultrasonography revealed an intracystic tumor in only male patient yet described [2]. "
    [Show abstract] [Hide abstract] ABSTRACT: Acinic cell carcinoma of the breast is an extremely rare, malignant neoplasm characterized by widespread acinar cell-like differentiation and clinically low-grade malignancy. Herein, we report a case of acinic cell carcinoma of the breast in a 41-year-old woman. The tumor was poorly demarcated but had a firm consistency. It was removed with lumpectomy, and sentinel lymph node biopsy was performed to check for metastasis. Microscopically, the tumor showed an infiltrative growth pattern with a combination of solid, trabecular, and microglandular areas. Many of the tumor cells had abundant clear vacuolated cytoplasm containing zymogen-typed granules which resemble acinar cells of the salivary glands. The immunohistochemical profile of the tumor was also similar to that of salivary gland acinic cell carcinoma: the tumor cells were positive for amylase, lysozyme, α -1-antichymotrypsin, S-100 protein, and epithelial membrane antigen and negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. She received postoperative chemoradiation therapy and has been well for 3 years since surgery. As studies on large series are lacking, further studies are needed to elucidate the biological characteristics of acinic cell carcinoma of the breast.
    Full-text · Article · Sep 2013
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