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June 1995

Acinic Cell Carcinoma of the Lacrimal Gland

Author Affiliations

From the Departments of Ophthalmology and Visual Sciences (Dr Rosenbaum), and the Department of Pathology (Drs Rosenbaum, Mahadevia, and Goodman and Ms Kress), Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.

Arch Ophthalmol. 1995;113(6):781-785. doi:10.1001/archopht.1995.01100060107044

An 18-year-old woman underwent exenteration of the right orbit for tumor recurrence 3 years subsequent to external-beam irradiation for a lacrimal gland tumor diagnosed as an "adenocarcinoma." Light microscopy of the exenteration specimen revealed an acinic cell carcinoma of the lacrimal gland, with a predominant microcystic (latticelike) pattern of growth. Cytoplasmic vacuoles and the secretion within the microcysts stained positive with periodic acid—Schiff with and without α-amylase, alcian blue (at a pH of 2.5), mucicarmine, and colloidal iron with and without hyaluronidase. This histochemical staining for epithelial mucins supports the theory that the lacrimal gland, although serous in type, may also function as a modified mucus gland. There was cytoplasmic immunopositivity for keratin (CAM 5.2, KAE 1-3); immunostaining for vasoactive intestinal polypeptide was negative. Electron microscopy disclosed undifferentiated features of intercalated duct cells. We speculate that the lack of immunoreactivity for vasoactive intestinal polypeptide may be correlated with the predominantly undifferentiated intercalated duct cell features observed ultrastructurally.