Univ. Of Alberta Medicine and Dentistry/Dept. of Laboratory Medicine & Pathology

History: The patient is a 32 year old female presenting with a lump in the left preauricular area. The mass has been present for 4 months.


  • composed of large cells resembling normal serous cells
  • abundant finely granular cytoplasm
  • some cytoplasmic vacuolization
  • clear round spaces visible throughout lesion
  • PAS positive cytoplasmic granules


  • highly cellular specimen
  • numerous single cells, sheets and syncytial groupings
  • moderate numbers of loose acinar arrangements
  • oval cells with eccentric nuclei and basophilic granular cytoplasm
  • cells in sheets had more centrally placed nuclei and were polygonal in shape
  • ound nuclei showing slight variation in size
  • small distinct nucleoli present
  • moderate numbers of stripped nuclei present

Diagnosis: Acinic Cell Carcinoma

Acinic cell carcinoma (ACC) is an uncommon low-grade malignancy of the salivary gland , comprising 2-3% of all salivary gland tumors with up to 90% of these lesions arising the parotid gland. They occur twice as frequently in women as in men, affecting primarily middle aged or elderly patients.


Cajulis RS, Gokaslan ST, Yu GH, Frias-Hidvegi D: Fine needle aspiration biopsy of the salivary gland. A five-year experience with emphasis on diagnostic pitfalls . Acta Cytol 1997;41: 1412-1420

Cawson RA, Eveson JW: Tumors of the salivary glands. In Diagnostic Histopathology of Tumors (Vol. I). Edited by CDM Fletcher, Churchill Livinstone, 1995, pp172

Kini SR, Color atlas of differential diagnosis in exfoliative and aspiration cytopathology. Baltimore, Wiliams & Wilkins, 1999, pp 298

Nagel H, Laskawi R, Buter JJ, Schroder M, Shilla R, Droese M: Cytologic diagnosis of acinic-cell carcinoma of salivary glands. Diagn Cytopathol 1997;16:402-411

Yang GCH, Kuhel WI: Uncommon tumors of the salivary gland in fine needle aspiration biopsies. A surgeon’s perspective. Acta Cytol 1997;41:1015-1022

Young, JA: The salivary glands. In Diagnostic Cytopathology. Edited by W Gray. Hong Kong , Churchill Livingstone, 1995, pp 307-308