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Acinar cell carcinoma of the pancreas with and without endocrine differentiation.

ABSTRACT: BACKGROUND: Acinar cell carcinoma (ACC) is a rare pancreatic neoplasm, representing 1% of exocrine tumours and containing a variable endocrine component. Three recent cases of ACC are reported. CASE OUTLINES: A 72-year-old man with painless obstructive jaundice had a 5-cm mass in the head of pancreas resected by Whipple's operation; histopathological examination showed a typical ACC. A 33-year-old man with weight loss and abnormal liver function had a dilated biliary tree but no mass on imaging. Pylorus-preserving pancreatoduodenectomy was performed, and histology showed a mixed acinar-neuro-endocrine tumour. A 56-year-old man with weight loss and a palpable mass had a 15-cm mass in the distal body of pancreas, which was resected en bloc with the spleen and adherent stomach; it was a cystic ACC. RESULTS: Two patients are alive and free of disease at 30 months and 15 months, while the third patient with locally advanced disease died of myocardial infarction at 9 weeks. DISCUSSION: Acinar structures are the hallmark of this neoplasm, which carries a better survival rate than ductal cancer. Surgical excision prolongs survival and offers the best chance of cure.

SUBMITTER: Virlos IT

PROVIDER: S-EPMC2020533 | biostudies-other | 2002

REPOSITORIES: biostudies-other

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Project description:Postnatal pancreas is a potential source for progenitor cells to generate endocrine β-cells for treating type 1 diabetes. However, it remains unclear whether young (1-week-old) pancreas harbors multipotent progenitors capable of differentiating into duct, acinar, and endocrine cells. Laminin is an extracellular matrix (ECM) protein important for β-cells' survival and function. We established an artificial extracellular matrix (aECM) protein that contains the functional IKVAV (Ile-Lys-Val-Ala-Val) sequence derived from laminin (designated aECM-lam). Whether IKVAV is necessary for endocrine differentiation in vitro is unknown. To answer these questions, we cultured single cells from 1-week-old pancreas in semi-solid media supplemented with aECM-lam, aECM-scr (which contains a scrambled sequence instead of IKVAV), or Matrigel. We found that colonies were generated in all materials. Individual colonies were examined by microfluidic reverse transcription-polymerase chain reaction, immunostaining, and electron microscopy analyses. The majority of the colonies expressed markers for endocrine, acinar, and ductal lineages, demonstrating tri-lineage potential of individual colony-forming progenitors. Colonies grown in aECM-lam expressed higher levels of endocrine markers Insulin1, Insulin2, and Glucagon compared with those grown in aECM-scr and Matrigel, indicating that the IKVAV sequence enhances endocrine differentiation. In contrast, Matrigel was inhibitory for endocrine gene expression. Colonies grown in aECM-lam displayed the hallmarks of functional β-cells: mature insulin granules and glucose-stimulated insulin secretion. Colony-forming progenitors were enriched in the CD133(high) fraction and among 230 micro-manipulated single CD133(high) cells, four gave rise to colonies that expressed tri-lineage markers. We conclude that young postnatal pancreas contains multipotent progenitor cells and that aECM-lam promotes differentiation of β-like cells in vitro.

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Acinar cell carcinoma of the pancreas with and without endocrine differentiation.

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