Pancreatic-type Acinar Cell Carcinoma of the Stomach Included in Multiple Primary Carcinomas.
OBJECTIVE
Pancreatic-type acinar cell carcinoma (ACC) in the stomach is extraordinarily rare. We pathologically examined two cases with multiple primary carcinomas, including gastric tumors.


METHODS
Gastric cancer specimens were examined by immunostaining and electron microscopy.


RESULTS
Both cases had cancer cells with acinar patterns, resembling pancreatic ACC. The cancer cells in the first case were positive for exocrine markers, including chymotrypsin, lipase and alpha-1 antichymotrypsin (ACT), as well as neuroendocrine markers, including chromogranin A and synaptophysin. The cancer cells in the second case were positive for chymotrypsin and alpha-1 ACT, while being slightly positive for chromogranin A and synaptophysin. Ultrastructurally, cancer cells contained zymogen granules in both cases. The final diagnosis was pancreatic mixed acinar-neuroendocrine carcinoma and pure pancreatic ACC, respectively.


CONCLUSIONS
We confirmed two cases with gastric pancreatic-type ACC included in multiple primary carcinomas. This type of double cancer has not been reported previously.
Department of Surgery, Nagahama City Hospital, Nagahama, Japan yoney@m.ehime-u.ac.jp.
Yoshikuni
Y
Yonenaga
Department of Diagnostic Pathology, Nagahama City Hospital, Nagahama, Japan.
Manabu
M
Kurosawa
Department of Surgery, Nagahama City Hospital, Nagahama, Japan.
Masahiro
M
Mise
Department of Nursing, Nagahama City Hospital, Nagahama, Japan.
Miki
M
Yamagishi
Department of Surgery, Nagahama City Hospital, Nagahama, Japan.
Shunichi
S
Higashide
D000368:Aged; D018267:Carcinoma, Acinar Cell / Q000401:mortality / Q000473:pathology* / Q000648:ultrastructure; D053379:Chromogranin A / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000648:ultrastructure; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000648:ultrastructure; D000514:alpha 1-Antichymotrypsin / Q000032:analysis
D053379:Chromogranin A; D000514:alpha 1-Antichymotrypsin
Acinar cell carcinoma; mixed acinar-neuroendocrine carcinoma; multiple primary carcinomas; pancreas; stomach