title: Pancreatic-type acinar cell carcinoma of the stomach beneath a focus of pancreatic metaplasia of the gastric mucosa.
abstract: Acinar cell carcinoma is an uncommon type of carcinoma of the pancreas that can exceptionally arise in ectopic pancreatic tissue. Herein, we report a case of a 52-year-old man with pancreatic-type acinar cell carcinoma of the stomach and concomitant pancreatic metaplasia of the adjacent nonneoplastic gastric mucosa. There was neither clinical nor radiographic evidence of a tumor in the pancreas itself. A subtotal gastrectomy was performed. Macroscopically, an ulcerated tumor, measuring 4 x 1.7 cm, was found in the distal antrum. Microscopically, the biopsy and the surgical specimen revealed a neoplasm with a predominantly trabecular architecture composed of moderately atypical cells with finely dispersed chromatin and indistinct nucleoli. The neoplastic cells and those of the adjacent metaplastic mucosa were both strongly immunoreactive for alpha-1-antitrypsin, consistent with pancreatic acinar cell differentiation. Ectopic pancreatic-type acinar cell carcinoma is an extremely rare condition, having been previously reported only in 5 occasions, none of them in association with pancreatic acinar cell metaplasia of the gastric mucosa.
authors.affiliation: Section of Anatomic Pathology, Department of Oncology and Hematology, University of Bologna, Bellaria Hospital, 40139 Bologna, Italy. andreaambrosini@yahoo.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Ambrosini-Spaltro
authors.forename: Oscar
authors.initials: O
authors.lastname: Potì
authors.forename: Michele
authors.initials: M
authors.lastname: De Palma
authors.forename: Marcello
authors.initials: M
authors.lastname: Filotico
mesh_terms: D018267:Carcinoma, Acinar Cell / Q000378:metabolism / Q000473:pathology*; D002454:Cell Differentiation; D005753:Gastric Mucosa / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism / Q000473:pathology*; D013274:Stomach Neoplasms / Q000378:metabolism / Q000473:pathology*; D000515:alpha 1-Antitrypsin / Q000096:biosynthesis
chemical_list: C043392:SERPINA1 protein, human; D000515:alpha 1-Antitrypsin