A rare case of pulmonary typical carcinoid with prominent acinic cell differentiation, resembling acinic cell carcinoma.

Abstract:

:We herein describe a rare case of low-grade endobronchial tumor that exhibited two distinct features of typical carcinoid and acinic cell carcinoma (ACC) by immunohistochemical and ultrastructure study. ACC was suspected on transbronchial biopsy. The resected specimen showed that the tumor surface comprised an acinic cell component (40% of the tumor), and the central area comprised typical carcinoid (60% of the tumor). The acinic cell component was positive for chromogranin A, synaptophysin and alpha-1-antichymotrypsin. Additionally, this component showed focal apical membranous staining for DOG1 and weak positivity for BCL10 and SOX10. Conversely, the carcinoid component was negative for all proteins except for chromogranin A and synaptophysin. Electron microscopy indicated zymogen-type granules (600-800 nm in diameter) in the acinic cell component, whereas neuroendocrine-type granules (200-300 nm in diameter) were observed in the carcinoid component. Nuclear NR4A3 immunostaining, which is highly specific for ACC of the salivary gland, was negative in this case. We conclude that the pulmonary carcinoid tumor with true zymogen-type granules could be seen but showed superficial similarities to ACC based on negative nuclear staining for NR4A3. Pulmonary carcinoids encompass a wide morphological spectrum and may exhibit prominent acinic cell differentiation.

journal_name

Pathol Int

journal_title

Pathology international

authors

Watanabe H,Miyagawa-Hayashino A,Imabayashi T,Kishimoto M,Shimomura M,Honda K,Omatsu I,Shimada E,Inoue M,Takayama K,Konishi E

doi

10.1111/pin.12869

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

721-726

issue

12

eissn

1320-5463

issn

1440-1827

journal_volume

69

pub_type

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