Acinic cell carcinoma classification: Difference between revisions

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Latest revision as of 17:20, 29 October 2019

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]

T: Primary Tumor


T	Description
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
Ta	Papillary noninvasive carcinoma
Tis	Carcinoma in situ
T1	Tumor invades subepithelial connective tissue
T2	Tumor invades the muscularis
T3	(For renal pelvis only) Tumor invades beyond muscularis into peripelvic fat or the renal parenchyma T3. (For ureter only) Tumor invades beyond muscularis into periureteric fat
T4	Tumor invades adjacent organs, or through the kidney into the perinephric fat

N:Regional Lymph Nodes


N	Description
NX	Regional lymph nodes cannot be assessed
N0	No regional lymph node metastasis
N1	Metastasis in a single lymph node, ≤2 cm in greatest dimension
N2	Metastasis in a single lymph node, >2 cm but not >5 cm in greatest dimension; or multiple lymph nodes, none >5 cm in greatest dimension
N3	Metastasis in a lymph node, >5 cm in greatest dimension

M: Distant Metastasis

T	Description
M0	There is no evidence of distant metastasis
M1	There is evidence of distant metastasis

TNM Classification

Stage	T	N	M
Stage 0a	Ta	N0	M0
Stage 0is	Tis	N0	M0
Stage I	T1	N0	M0
Stage II	T2	N0	M0
Stage III	T3	N0	M0
Stage IV	T4	N0	M0
	Any T	N1	M0
	Any T	N2	M0
	Any T	N3	M0
	Any T	Any N	M1

* 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

↑ 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.
↑ 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.

Template:WH Template:WS

[SonPanwar2018-1] 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.

[ChioseaGriffith2012-2] 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.

[1]

[2]

@@ Line 3: / Line 3: @@
 {{CMG}}; {{AE}} {{RG}}
 ==Overview==
-According to the 8th edition of [https://cancerstaging.org/references-tools/deskreferences/pages/default.aspx American Joint Committee on Cancer](AJCC) and [https://www.uicc.org 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]].
+Based on the 8th edition of [[American Joint Committee on Cancer]]([[American Joint Committee on Cancer|AJCC]]) and Union for International Cancer Control ([[International Union Against Cancer|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==
-According to the 8th edition of [https://cancerstaging.org/references-tools/deskreferences/pages/default.aspx American Joint Committee on Cancer](AJCC) and [https://www.uicc.org Union for International Cancer Control (UICC)]the staging of [[salivary gland]] neoplasms are staged by [[TNM system]].<ref name="SonPanwar2018">{{cite journal|last1=Son|first1=Eugene|last2=Panwar|first2=Aru|last3=Mosher|first3=Charles H.|last4=Lydiatt|first4=Daniel|title=Cancers of the Major Salivary Gland|journal=Journal of Oncology Practice|volume=14|issue=2|year=2018|pages=99–108|issn=1554-7477|doi=10.1200/JOP.2017.026856}}</ref> This means [[acinic cell carcinoma]] is staged based on tumor, node, and [[metastasis]] similar to [[squamous cell carcinoma]].
+Based on the 8th edition of [[American Joint Committee on Cancer]]([[AJCC]]) and Union for International Cancer Control ([[International Union Against Cancer|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]].<ref name="SonPanwar2018">{{cite journal|last1=Son|first1=Eugene|last2=Panwar|first2=Aru|last3=Mosher|first3=Charles H.|last4=Lydiatt|first4=Daniel|title=Cancers of the Major Salivary Gland|journal=Journal of Oncology Practice|volume=14|issue=2|year=2018|pages=99–108|issn=1554-7477|doi=10.1200/JOP.2017.026856}}</ref>
-<br />
+===T: Primary Tumor===
-{| class="wikitable"
+{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
-!T category
+|+
-!N category
+! style="background: #4682B4; color:#FFF;" | T
-!M category
+! style="background: #4682B4; color:#FFF;" | Description
 |-
-|TX: Primary tumor cannot be assessed
+| style="padding: 5px 5px; background: #B8B8B8;" | TX
-|NX: Regional lymph nodes cannot be assessed
+| style="padding: 5px 5px; background: #e4e4e4;" | Primary tumor cannot be assessed
-|M0: No distant metastasis
 |-
-|T0: No evidence of primary tumor
+| style="padding: 5px 5px; background: #B8B8B8;" | T0
-|N0: No regional lymph node metastasis
+| style="padding: 5px 5px; background: #e4e4e4;" | No evidence of primary tumor
-|M1: Distant metastasis
 |-
-|Tis: Carcinoma ''in situ''
+| style="padding: 5px 5px; background: #B8B8B8;" | Ta
-|N1: Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(–)
+| style="padding: 5px 5px; background: #e4e4e4;" | Papillary noninvasive carcinoma
-|
 |-
-|T1: Tumor 2 cm or smaller in greatest dimension without extraparenchymal extension
+| style="padding: 5px 5px; background: #B8B8B8;" | Tis
-|N2:Metastasis in a single ipsilateral lymph node, 3 cm or smaller in greatest dimension and ENE(+); '''or'''
+| style="padding: 5px 5px; background: #e4e4e4;" | Carcinoma in situ
-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
+| style="padding: 5px 5px; background: #B8B8B8;" | T1
-|N2a: Metastasis in single ipsilateral node 3 cm or smaller in greatest dimension and ENE(+); '''or'''
+| style="padding: 5px 5px; background: #e4e4e4;" | Tumor invades subepithelial connective tissue
-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
+| style="padding: 5px 5px; background: #B8B8B8;" | T2
-|N2b: Metastases in multiple ipsilateral nodes, none larger than 6 cm in greatest dimension and ENE(–)
+| style="padding: 5px 5px; background: #e4e4e4;" | Tumor invades the muscularis
-|
 |-
-|T4a: Moderately advanced disease.
+| style="padding: 5px 5px; background: #B8B8B8;" | T3
-Tumor invades skin, mandible, ear canal, and/or facial nerve.
+| style="padding: 5px 5px; background: #e4e4e4;" | (For renal pelvis only) Tumor invades beyond muscularis into peripelvic fat or the renal parenchyma T3. (For ureter only) Tumor invades beyond muscularis into periureteric fat
-|N2c: Metastases in bilateral or contralateral lymph node(s), none larger than 6 cm in greatest dimension and ENE(–)
-|
 |-
-|T4b:Very advanced disease.
+| style="padding: 5px 5px; background: #B8B8B8;" | T4
-Tumor invades skull base and/or pterygoid plates and/or encases carotid artery.
+| style="padding: 5px 5px; background: #e4e4e4;" | Tumor invades adjacent organs, or through the kidney into the perinephric fat
-|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'''
+===N:Regional Lymph Nodes===
-A single contralateral node of any size and ENE(+)
+{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
-|
+|+
+! style="background: #4682B4; color:#FFF;" | N
+! style="background: #4682B4; color:#FFF;" | Description
 |-
-|
+| style="padding: 5px 5px; background: #B8B8B8;" | NX
-|N3a: Metastasis in a lymph node larger than 6 cm in greatest dimension and ENE(–)
+| style="padding: 5px 5px; background: #e4e4e4;" | Regional lymph nodes cannot be assessed
-|
 |-
-|
+| style="padding: 5px 5px; background: #B8B8B8;" | N0
-|N3b: Metastasis in a single ipsilateral node larger than 3 cm in greatest dimension and ENE(+); '''or'''
+| style="padding: 5px 5px; background: #e4e4e4;" | No regional lymph node metastasis
-Multiple ipsilateral, contralateral, or bilateral nodes any with ENE(+); '''or'''
+|-
-A single contralateral node of any size and ENE(+)
+| style="padding: 5px 5px; background: #B8B8B8;" | N1
-|
+| style="padding: 5px 5px; background: #e4e4e4;" | Metastasis in a single lymph node, ≤2 cm in greatest dimension
+|-
+| style="padding: 5px 5px; background: #B8B8B8;" | N2
+| style="padding: 5px 5px; background: #e4e4e4;" | Metastasis in a single lymph node, >2 cm but not >5 cm in greatest dimension; or multiple lymph nodes, none >5 cm in greatest dimension
+|-
+| style="padding: 5px 5px; background: #B8B8B8;" | N3
+| style="padding: 5px 5px; background: #e4e4e4;" | Metastasis in a lymph node, >5 cm in greatest dimension
 |}
+===M: Distant Metastasis===
+{| style="cellpadding=0; cellspacing= 0; width: 600px;"
+|-
+| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF; width: 10%" align=center |'''T'''||style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF" align=center |'''Description'''
+|-
+|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |M0 ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |There is no evidence of distant [[metastasis]]
+|-
+|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |M1 ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |There is evidence of [[distant]] metastasis
+|}
+===TNM Classification===
+{| style="cellpadding=0; cellspacing= 0; width: 600px;"
+|-
+| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF" align=center |'''Stage'''||style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF" align=center |'''T'''||style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF" align=center |'''N'''||style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF" align=center |'''M'''
+|-
+|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Stage 0a''' || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |Ta ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left | N0 || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |M0
+|-
+|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Stage 0is''' || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |Tis || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |N0 || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |M0
+|-
+|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Stage I''' || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |T1 || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |N0 ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left | M0
+|-
+|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Stage II''' || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |T2 || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |N0 || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |M0
+|-
+|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''Stage III''' || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |T3 || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |N0 || style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |M0
+|-
+|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left rowspan="5"|'''Stage IV''' ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |T4|| style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |N0 ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |M0
+|-
+|style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |Any T ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |N1 ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |M0
+|-
+|style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |Any T ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |N2 ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |M0
+|-
+|style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |Any T ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |N3 ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |M0
+|-
+|style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |Any T ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |Any N ||style="font-size: 100; padding: 0 5px; background: #e4e4e4" align=left |M1
+|}* Acinic cell carcinoma is classified due its different histiological featurs as bellow:<ref name="ChioseaGriffith2012">{{cite journal|last1=Chiosea|first1=Simion I.|last2=Griffith|first2=Christopher|last3=Assaad|first3=Adel|last4=Seethala|first4=Raja R.|title=The Profile of Acinic Cell Carcinoma After Recognition of Mammary Analog Secretory Carcinoma|journal=The American Journal of Surgical Pathology|volume=36|issue=3|year=2012|pages=343–350|issn=0147-5185|doi=10.1097/PAS.0b013e318242a5b0}}</ref>
+<br />
+{| class="wikitable"
+|+
+! style="padding: 5px 5px; background: #4479BA; fontcolor: #FFF" font-weight: bold" align="center" colspan="2" |Acinic-intercalated ductal carcinoma family
+|-
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |Solid acinic cell carcinoma
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: italic" align="center" |''Serous cells adenocarsinoma''
+|-
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |Cacinomas of various proportions
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: italic" align="center" |''Various proportion of acinic and intercalated duct-like cells''
+|-
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |Carcinomas intercalated duct-like cells
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: italic" align="center" |''Microcytic, papillary, follicular, cystic and mixed architectural arrangments''
+|-
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |s-100  protein (-)
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: italic" align="center" |''Considered immunohistochemisty for DOGI''
+|-
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: bold" align="center" |s-100 protein (+)/MASC
+| style="padding: 5px 5px; background: #F5F5F5; font-weight: italic" align="center" |''Consider immunohistochemistry for mammaglobin, ETV6 FISH''
+|}
+<br />
 ==References==
 {{Reflist|2}}