Pancreatic acinar cell carcinoma: A comprehensive review

Table 2 Summary of pertinent differential diagnostic features

Differential diagnoses	Age/sex	Imaging/gross findings	Histology	Prognosis
ACC	Predominant in males; mean age of 62 yr	Solid, well-circumscribed, bulky tumors; hemorrhage and necrosis are also frequent	Predominant acinar or solid architecture; uniform cells; basally located nuclei; eosinophilic granular cytoplasm; prominent single nucleoli. minimal stroma	Overall aggressive, with high rates of recurrence and metastasis
PDAC	Slightly higher in males; 6th-8th decade of life	Solid, poorly defined mass	Large, medium, or small malignant ducts with a tubular pattern; desmoplastic stroma. Processes of mitosis and necrosis	Poor survival rates
PanNET	Even distribution between the genders; more prevalent in adults; mean age of 40	Solid, well-circumscribed. 5% are cystic	Variable architectural patterns; uniform cells; oval or spherical nuclei; granular cytoplasm; undetected nucleoli; minimal stroma	Relatively languid, but with variable results
SPN	Almost exclusively female; average age of 28	Well-defined and encased with cystic degeneration	Pseudopapillae; cells with hyaline/myxoid stroma surrounding vessels; large cytoplasmic hyaline globules; nuclear groove	Overall low malignant potential: The majority are successfully treated surgically
PBL	First decade of life, mean age of 4; adults can be affected	Partially encapsulated, frequently lobulated, and substantial	Solid and acinar structure; cellular stroma; keratinization of squamoid nests; heterologous mesenchymal elements	Aggressive; better outcomes for children

ACC: Acinar cell carcinoma; PanNET: Pancreatic neuroendocrine tumors; PBL: Pancreatoblastoma; SPN: Solid pseudopapillary neoplasm; PDAC: Pancreatic ductal carcinoma