Cytomorphologic, immunophenotypical and molecular features of pancreatic acinar cell carcinoma

As a rare tumor in pancreas, pancreatic acinar cell carcinoma (PACC) possesses a distinct molecular feature from pancreatic ductal carcinoma (PDAC). Though the diagnosis of PACC is often established based on cytology specimens, its cytologic diagnosis can be challenging. Furthermore, the correlation...

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Bibliographic Details
Published in:Diagnostic cytopathology 2023-11, Vol.51 (11), p.674-683
Main Authors: Sun, Tong, Gilani, Syed, Jain, Dhanpat, Cai, Guoping
Format: Article
Language:English
Subjects:
Cancer
Carcinoma, Acinar Cell - genetics
Carcinoma, Acinar Cell - pathology
Carcinoma, Pancreatic Ductal - pathology
Cellular biology
Humans
Mutation
Pancreas - pathology
Pancreatic Neoplasms
Pancreatic Neoplasms - genetics
Pancreatic Neoplasms - pathology
Repressor Proteins
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Summary:As a rare tumor in pancreas, pancreatic acinar cell carcinoma (PACC) possesses a distinct molecular feature from pancreatic ductal carcinoma (PDAC). Though the diagnosis of PACC is often established based on cytology specimens, its cytologic diagnosis can be challenging. Furthermore, the correlation between PACC cytomorphology and its unique different molecular alterations have not been fully explored. Cytology features were analyzed in 8 histologically proven PACC and cytohistological correlation was performed. Immunocytochemistry for trypsin, chymotrypsin, BCL10, synaptophysin, chromogranin A, INSM1, β-catenin, and Ki-67 was assessed. Comprehensive molecular profiling and additional targetable treatment biomarker assessment were also performed. The cohort included 4 mixed acinar-neuroendocrine carcinomas, 3 pure PACCs, and 1 mixed acinar-ductal carcinoma. Immunophenotypical features are consistent with diagnoses of PACC or PACC with neuroendocrine features. Identified genetic alterations included somatic mutations of CTNNB1, TP53, MAP2K1, PTEN, RAC1, germline mutations of NBN and BRAC2, and gene fusion of CCDC6-RET. The current study is the first attempt to explore the correlation between the cytomorphology characteristics and molecular features of PACC and a few intriguing findings were observed. Further validation in larger cohorts is warranted.
ISSN:8755-1039
1097-0339
DOI:10.1002/dc.25196