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Pulmonary Pathology Online

Pathology of Acinic Cell Carcinoma (Fechner Tumour) of the Lung

 Dr Sampurna Roy MD  




Primary acinic cell carcinomas of the lung are rare tumours, usually presenting in adulthood as parenchymal or endobronchial masses.

The tumour has also been reported in children. 

Histologically, the tumours are composed of clear cells with abundant granular cytoplasm growing as solid sheets with focal acinar, microcystic, and papillocystic areas.  


These lesions are generally recognized by their morphological pattern and the presence of large cells with abundant bright cytoplasm and periodic acid-Schiff (PAS)-positive, diastase-resistant cytoplasmic granules.

Signet cell formation sometimes occurs. 

Electron microscopic examination reveals abundant secretory granules.

Immunohistochemical stains are of limited value in this tumour.

Immunohistochemical stains may show strong positivity of the tumor cells for low-molecular-weight cytokeratins and epithelial membrane antigen (EMA).

In some cases focal weak cytoplasmic positivity has been observed with alpha-1-antichymotrypsin and with amylase.

Stains for  S-100 protein, chromogranin, and lysozyme are usually negative.

Because of their relatively indolent behavior and favorable prognosis, primary acinic cell carcinoma of the lung must be distinguished from other primary and metastatic clear cell tumours of the lung.

Further reading:

Acinic cell carcinoma of the lung ("Fechner tumor"). A clinicopathologic, immunohistochemical, and ultrastructural study of five cases.

Acinic cell carcinoma: an unusual cause of bronchial obstruction in a child.

Fine-needle aspiration cytology of bronchial acinic cell carcinoma: a case report.

Primary acinic cell carcinoma of the lung with lymph node metastasis.

Acinic cell carcinoma of the lung with metastasis to lymph nodes.

Acinic cell carcinoma of the trachea: report of a case.

Acinic cell carcinoma of the trachea.

Acinic cell carcinoma of the trachea--a case report.

Predominantly mucous-differentiated acinic cell adenocarcinoma of the trachea



Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)







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