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WHO Classification of Tumours
Acinar cell cystadenoma
Pancreas


Histopathology

Acinar cell cystadenomas produce variably sized cysts; some are little more than slightly dilated acinar-like spaces, whereas others are more substantial. Most of the cysts are lined by well-differentiated cells with acinar differentiation, either in a single layer or forming small clusters of cells surrounding the lumen
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Albores-Saavedra J (2002)
Acinar cystadenoma of the pancreas: a previously undescribed tumor.
Ann Diagn Pathol 6: 113-5




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Chatelain D, Paye F, Mourra N, Scoazec JY, Baudrimont M, Parc R, Flejou JF (2002)
Unilocular acinar cell cystadenoma of the pancreas an unusual acinar cell tumor.
Am J Clin Pathol 118: 211-4




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Zamboni G, Terris B, Scarpa A, Kosmahl M, Capelli P, Klimstra DS, Lam PW, Klöppel G (2002)
Acinar cell cystadenoma of the pancreas: a new entity?
Am J Surg Pathol 26: 698-704



. Residual pancreatic elements are present between the larger cysts, and some of the adjacent acini may be dilated. The lesional cells have basally situated, uniform nuclei, apical granular eosinophilic cytoplasm, and basal cytoplasmic basophilia, resembling non-neoplastic acinar cells. In some cases, the cysts are partially lined by cuboidal cells that lack cytoplasmic granules and that instead resemble normal ductal epithelium. Incidental microscopic cases may consist of a single cyst lined by cells with acinar differentiation. Transitions to ductal epithelium including cells with columnar, mucinous cytoplasm (low-grade pancreatic intraepithelial neoplasia, PanIN) may be found. The cyst lumina may contain inspissated eosinophilic enzymatic secretions. The surrounding pancreatic parenchyma is typically fibrotic and atrophic. The lining cells stain with periodic acid–Schiff and are resistant to diastase. Staining for mucins is negative
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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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> Differential diagnosis
Small, incidental acinar cell cystadenomas can resemble PanINs. Recognition of the granular eosinophilic cytoplasm and the absence of mucin help confirm the diagnosis of acinar cell cystadenoma. Larger acinar cell cystadenomas can be confused with serous cystic neoplasms, squamoid cyst of pancreatic ducts, or mucinous cystic neoplasms (MCNs). Again, recognition of acinar differentiation is very helpful. Acinar cell cystadenomas lack the clear cells of serous cystic neoplasms, the squamous differentiation of squamoid cysts, and the mucinous cells and ovarian-type stroma of MCNs

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Othman M, Basturk O, Groisman G, Krasinskas A, Adsay NV (2007)
Squamoid cyst of pancreatic ducts: A distinct type of cystic lesion in the pancreas.
Am J Surg Pathol 31: 291-7



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Small acinar cell cystadenoma
Small acinar cell cystadenoma
Cystic structures lined by acinar cells
Cystic structures lined by acinar cells