Atypical and neoplastic acinar cell lesions of the pancreas in an autopsy study of Japanese patients

Abstract

A histopathologic examination of the pancreas was performed on a series of adult Japanese autopsies. In ten of 162 pancreases (6%) with adequate tissue available, two types of focal atypical acinar cell lesions, composed of acidophilic or basophilic cells, were found. Acidophilic atypical acinar cell lesions were more frequent than basophilic ones, although the one case of acinar cell adenoma and two cases of acinar cell carcinomas showed high incidences of basophilic atypical acinar cell lesions. The findings are concluded to support the possibility that atypical acinar cell lesions are precursors for acinar cell carcinomas. Cancer 61:2278-2285,1988. HE INCIDENCE OF PANCREATIC cancer has in-T creased somewhat in recent including cases in J a ~ a n. ~-~ In pancreatic exocrine cancers duct cell adenocarcinoma is the most common type, representing more than 75% of The incidence of carcinoma in situ in the duct epithelium is 24% in patients with pancreatic ~ a n c e r. ~ In addition, atypical or dysplastic epithelial lesions in the pancreatic ducts have been found in association with pancreatic carcinoma more frequently than in noncancerous pancreases. It has therefore been assumed that these cancers arise from ductal epithelium. lo The other principal type of pancreatic cancer, which represents up to 15% of pancreatic carcinomas, is acinar cell carcinoma, which is assumed to originate from the acinar cell^.^,^^'^ This interpretation is supported by findings from experimental pancreatic carcinogenesis in which carcinogen-induced atypical acinar cell foci (AACF) or atypical acinar cell nodules (AACN) have been identified as possible precursor lesions of acinar cell car~inoma.~-'~ Atypical acinar cell lesions resembling those of experimentally induced pancreatic lesions in rats also have been reported in the human pan-creas. I4-l7 To determine the frequency of human atypical acinar cell lesions in a low-risk population, we studied a series of autopsies performed at a university medical center in Gifu prefecture in western Japan. This article describes the morphologic characteristics of the pancreatic lesions and the clinical information on the patients. Materials and Methods Pancreas tissue sections from 22 1 autopsies performed from 1974 to 1983 at the Gifu University School of Medicine in Gifu prefecture, Japan were studied. To be selected for review, a postmortem interval of no longer than 6 hours from death until fixation of the pancreas was required. This would ensure adequate tissue quality for study. All pancreases were fixed in 10% formalin and stained with hematoxylin and eosin. Of the 174 cases, 162 pancreases without autolysis were found to be suitable for quantitative histopathologic study. The 162 patients with adequate pancreatic tissue ranged in age from 30 to 89 years. Ninety-nine (61%) were men and 63 (39%) were women. The mean age of males was 60 for men, 6 1 for women. Eighty-five of the patients from which adequate pancreatic tissue was obtained had died in the following numbers of the following c...

Nonductal neoplasms of the pancreas

“…Acinar cell nodules 6,7 are small, circumscribed collections of cytologically altered acinar cells. Careful examination reveals basal polarization of the nuclei and apical cytoplasmic zymogen granules, distinguishing acinar cell nodules from endocrine microadenomas.…”

The pathobiological impact of cigarette smoke on pancreatic cancer development (Review)

“…In addition to cellular hyperplasia, two types of focal atypical acinar cell lesions associated with cigarette smoking have been described and differentiated by their staining properties in hematoxylin and eosin (H&E) staining, one of which shows predominantly acidophilic cells, the other basophilic cells (55). Electron microscopy reveals dilated rough endoplasmic reticulum and few zymogen granules.…”