Purpose
Acinar cell cystadenoma (ACC) is an uncommon entity with unknown physiopathology described for the first time in 2002 (1-3).
Its diagnosis is based on pathological criteria: cystic lesion with epithelial lining of typical acinar cells without atypia (fig 1-2).
15 cases (8 of them multilocular) had been reported in litterature (1-7) but fully described pattern correlated with pathology was not reported.
Most of the time,
patients presented abdominal pain and preoperative diagnosis was branch duct intraductal papillary and mucinous neoplasia (BD-IPMN).
Unlike IPMN,
ACC seems...
Methods and Materials
A monocentric retrospective study was conducted including all patients (five) operated with confirmed pathological diagnosis of ACC with pre-operative imaging (CT and/or MRI) from 1996 to 2012.
Twenty successive patients with resected BD-IPMN without malignant transformation and with pre-operative MRI were also included in a “control group”.
The study was approved by our local institutional review board and patient consent was waived.
Cases
Five patients (four women and one man),
26 to 59 years old at diagnosis were included.
Twenty successive patients (eleven women and...
Results
Clinical and biological findings
Clinical and biological findings of patients with ACC and BD-IPMN are described in table 1 :
Patient
ACC n=5
BD-IPMN n=20
p value
Clinical features
Sex (Female)
4 (80%)
12 (60%)
0,4
Age (years)
38,8 (8.01)
57,9 (13,30)
0.0059
Personal past history
1 Rheumatoid arthritis
1 duodenal adenocarcinoma
-
1 breast cancer
Familial history
1 Pancreatic adenocarcinoma
1 pulmonar carcinoma
1 diabetes
1 pancreatic
adenocarcinoma
-
Diabetes
1 (20%)
0
0,04
Exocrine pancreatic failure
0
0
-
Symptoms
Pancreatic pain
4...
Conclusion
Our study described for the first time imaging criteria of acinar cell cystadenoma.
Based on radio-pathological correlation,
we determined 4 morphological criteria which allowed us to differentiate ACC from its main differential diagnosis,
IPMN.
ACC appeared as a radiological entity,
made of numerous,
often calcified “close peripheral small cysts“,
without communication with the main pancreatic duct.
Unlike IPMN,
ACC seems to haveno malignant potential.
Thus,
their early recognition may lead to conservative or minimal invasive treatment,
rather than a more aggressive strategy.
References
1.
Chatelain D,
Paye F,
Mourra N,
Scoazec JY,
Baudrimont M,
Parc R,
et al.
Unilocular acinar cell cystadenoma of the pancreas an unusual acinar cell tumor.
Am J Clin Pathol.
2002 Aug;118(2):211-4.
2.
Albores-Saavedra J.
Acinar cystadenoma of the pancreas: a previously undescribed tumor.
Ann Diagn Pathol.
2002 Apr;6(2):113-5.
3.
Zamboni G,
Terris B,
Scarpa A,
Kosmahl M,
Capelli P,
Klimstra DS,
et al.
Acinar cell cystadenoma of the pancreas: a new entity? Am J Surg Pathol.
2002 Jun;26(6):698-704.
4.
Couvelard A,
Terris B,...