Abstract
An alpha fetoprotein (AFP)-producing tumour occurring in the head of the pancreas of a 30-year-old woman is reported. Histological examination revealed a markedly solid proliferation of tumour cells with prominent nucleoli and occasional luminal structures, some of which contained mucinous material stained with mucicarmine and alcian blue. No squamoid corpuscles were recognized. Immunohistochemistry showed intense positivity for lipase trypsin, and AFP basically, and single cells were also positive for carcino-embryonic antigen, CA19-9, synaptophysin and neuron-specific enolase. Pancreatic hormone-positive cells were absent. Electron microscopical examination revealed numerous granules of variable sizes in the tumour cells, which were considered to be zymogen. The tumour is an acinar cell carcinoma with multi-directional differentiation including the ability to produce AFP. Among AFP-positive pancreatic tumours, acinar cell carcinoma and pancreatoblastoma seem to be the most frequent.
Similar content being viewed by others
References
Buchino JJ, Castello FM, Nagaraj HS (1984) Pancreatoblastoma: a histochemical and ultrastructural analysis. Cancer 53: 963–969
Chen J, Baithun SI (1985) Morphological study of 391 cases of exocrine pancreatic tumors with special reference to the classification of exocrine pancreatic carcinoma. J Pathol (Lond) 146: 17–29
Cubilla AL, Fitzgerald PJ (1984) Tumors of the exocrine pancreas. In: Atlas of tumor pathology (ser 2, fasc 19). Armed Forces Institute of Pathology, Washington, DC, pp 208–212
Fitzgerald PJ, Fortner JG, Watson RC, et al (1978) The value of diagnostic aids in detecting pancreas cancer. Cancer 41: 868–879
Flaks B (1984) Histogenesis of pancreatic carcinogenesis in the hamster: ultrastructural evidence. Environ Health Perspect 56: 187–203
Gitlin D, Perricelli A, Gitlin GM (1972) Synthesis of alpha-fetoprotein by liver, yolk sac and gastrointestinal tract of the human conceptus. Cancer Res 32: 979–982
Haglund C, Lindgren J, Roberts PJ, et al (1986) Gastrointestinal cancer-associated antigen CA 19–9 in histological specimens of pancreatic tumours and pancreatitis. Br J Cancer 53: 189–195
Hoorens A, Lemoine NR, McLellan E, et al (1993) Pancreatic acinar cell carcinoma: an analysis of cell lineage markers, p53 expression, and Ki-ras mutation. Am J Pathol 143: 685–698
Reference deleted
Ichida H, Komada Y, Inokuchi T, et al (1977) Pancreatic cancer (in Japanese). Nippon Rinsho 35: 3476–3477
Ishikura H, Kirimoto K, Shamoto M, et al (1986) Hepatoid adenocarcinoma of the stomach: an analysis of seven cases. Cancer 58: 119–126
Itoh T, Kishi K, Tojo M, et al (1992) Acinar cell carcinoma of the pancreas with elevated serum a-fetoprotein levels: a case report and a review of 28 cases reported in Japan. Gastroenterol Jpn 27: 785–791
Reference deleted
Klimstra DS, Heffess CS, Oertel JE, et al (1992) Acinar cell carcinoma of the pancreas: a clinicopathologic study of 28 cases. Am J Surg Pathol 16: 815–837
Klimstra DS, Rosai J, Heffess CS, et al (1994) Mixed acinar endocrine carcinomas of the pancreas. Am J Surg Pathol 18: 765–778
Le Douarin NM (1978) The embryological origin of the endocrine cells associated with the digestive tract: experimental analysis based on the use of a stable cell marking technique. In: Bloom SR (ed) Gut hormones. Edinburgh, New York, Churchill Livingstone, pp 49–56
McIntire KR, Waldmann TA, Moertel CG, Go VLW (1975) Serum α-fetoprotein in patients with neoplasms of the gastrointestinal tract. Cancer Res 35: 991–996
Morohoshi T, Held G, Klöppel G (1983) Exocrine pancreatic tumors and their histological classification. A study based on 167 autopsy and 97 surgical cases. Histopathology 7: 645–661
Morohoshi T, Kanda M, Horie A, et al (1987) Immunocytochemical markers of uncommon pancreatic tumors: acinar cell carcinoma, pancreatoblastoma, and solid cystic (papillary-cystic) tumor. Cancer 59: 739–747
Nojima T, Kojima T, Kato H, et al (1992) Alpha-fetoprotein-producing acinar cell carcinoma of the pancreas. Hum Pathol 23: 828–830
Nonomura A, Kono N, Mizukami Y, et al (1992) Ductal-acinar-islet cell tumor of the pancreas. Ultrastruct Pathol 16: 317–329
Ohaki Y, Misugi K, Fukuda J, Okudaira M, Hirose M (1987) Immunohistochemical study of pancreatoblastoma. Acta Pathol Jpn 37: 1581–1590
Reference deleted
Ooi A, Nakanishi I, Sakamoto N, et al (1990) Alpha-fetoprotein (AFP)-producing gastric carcinoma. Is it hepatoid differentiation? Cancer 65: 1741–1747
Parsa I, Longnecker DS, Scarpelli DG, et al (1985) Ductal metaplasia of human exocrine pancreas and its association with carcinoma. Cancer Res 45: 1285–1290
Pour P (1978) Islet cells as a component of pancreatic ductal neoplasms. Am J Pathol 90:295–316
Rao MS, Scarpelli DG, Reddy JK (1986) Transdifferentiated hepatocytes in rat pancreas in pancreatic. Curr Top Dev Biol 20: 63–78
Scheithauer W, Chott A, Knoflauch P (1989) Alfa-fetoprotein-positive adenocarcinoma of the pancreas. A case report. Int J Pancreatol 4: 99–103
Schron DS, Mendelsohn G (1984) Pancreatic carcinoma with duct, endocrine, and acinar differentiation: a histologic, immunocytochemical, and ultrastructural study. Cancer 54: 1766–1770
Tucker JA, Shelburne JD, Benning TL, et al (1994) Filamentous inclusions in acinar cell carcinoma of the pancreas. Ultrastruct Pathol 18: 279–286
Ulich T, Cheng L, Lewin K (1982) Acinar-endocrine cell tumor of the pancreas: report of a pancreatic tumor containing both zymogen and neuroendocrine granules. Cancer 50: 2099–2105
Webb JN (1977) Acinar cell neoplasms of the exocrine pancreas. J Clin Pathol 30:103–112
Wiedenmann B, Rosenwicz S, Riecken EO, et al (1991) Pancreatic acinar carcinomas are amphicrine: combined expression of exocrine and endocrine secretory vesicles (abstract). Gastroenterology 100: A305
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Shinagawa, T., Tadakoro, M., Maeyama, S. et al. Alpha fetoprotein-producing acinar cell carcinoma of the pancreas showing multiple lines of differentiation. Vichows Archiv A Pathol Anat 426, 419–423 (1995). https://doi.org/10.1007/BF00191352
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00191352