Acinic cell carcinoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

Overview

Based on the 8th edition of American Joint Committee on Cancer(AJCC) and Union for International Cancer Control (UICC)the staging of salivary gland neoplasms are staged by TNM system.This means acinic cell carcinoma is staged based on tumor, node, and metastasis similar to squamous cell carcinoma.

Classification

Based on the 8th edition of American Joint Committee on Cancer(AJCC) and Union for International Cancer Control (UICC) the staging of salivary gland neoplasms are staged by TNM system. This means acinic cell carcinoma is staged based on tumor, node, and metastasis similar to squamous cell carcinoma.[1]


TNM staging
T category N category M category
TX: Primary tumor cannot be assessed NX: Regional lymph nodes cannot be assessed M0: No distant metastasis
T0: No evidence of primary tumor N0: No regional lymph node metastasis M1: Distant metastasis
Tis: Carcinoma in situ N1: Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(–)
T1: Tumor 2 cm or smaller in greatest dimension without extraparenchymal extension N2:Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); or

Larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(–); or Metastases in multiple ipsilateral lymph node(s), none larger than 6 cm in greatest dimension and ENE(–); or In bilateral or contralateral lymph nodes, none larger than 6 cm in greatest dimension and ENE(–)

T2: Tumor larger than 2 cm but not larger than 4 cm in greatest dimension without extraparenchymal extension N2a: Metastasis in single ipsilateral node 3 cm or smaller in greatest dimension and ENE(+); or

A single ipsilateral node larger than 3 cm but not larger than 6 cm in greatest dimension and ENE(–)

T3: Tumor larger than 4 cm and/or tumor having extraparenchymal extension N2b: Metastases in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and ENE(–)
T4a: Moderately advanced disease.

Tumor invades skin, mandible, ear canal, and/or facial nerve.

N2c: Metastases in bilateral or contralateral lymph node(s), none larger than 6 cm in greatest dimension and ENE(–)
T4b:Very advanced disease.

Tumor invades skull base and/or pterygoid plates and/or encases carotid artery.

N3: Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(–); or

In a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or Multiple ipsilateral, contralateral, or bilateral nodes any with ENE(+); or A single contralateral node of any size and ENE(+)

N3a: Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(–)
N3b: Metastasis in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); or

Multiple ipsilateral, contralateral, or bilateral nodes any with ENE(+); or A single contralateral node of any size and ENE(+)

  • Acinic cell carcinoma is classified due its different histiological featurs as bellow:[2]


Acinic-intercalated ductal carcinoma family
Solid acinic cell carcinoma Serous cells adenocarsinoma
Cacinomas of various proportions Various proportion of acinic and intercalated duct-like cells
Carcinomas intercalated duct-like cells Microcytic, papillary, follicular, cystic and mixed architectural arrangments
s-100 protein (-) Considered immunohistochemisty for DOGI
s-100 protein (+)/MASC Consider immunohistochemistry for mammaglobin, ETV6 FISH


References

  1. Son, Eugene; Panwar, Aru; Mosher, Charles H.; Lydiatt, Daniel (2018). "Cancers of the Major Salivary Gland". Journal of Oncology Practice. 14 (2): 99–108. doi:10.1200/JOP.2017.026856. ISSN 1554-7477.
  2. Chiosea, Simion I.; Griffith, Christopher; Assaad, Adel; Seethala, Raja R. (2012). "The Profile of Acinic Cell Carcinoma After Recognition of Mammary Analog Secretory Carcinoma". The American Journal of Surgical Pathology. 36 (3): 343–350. doi:10.1097/PAS.0b013e318242a5b0. ISSN 0147-5185.

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