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Immunohistochemistry of Acinar Cell CA of Pancreas: Markers of acinar differentiation are extremely useful in differentiating acinar cell carcinoma from its mimics. However, sensitivity of monoclonal antibodies used for their detection is variable. The markers include: trypsin, chymotrypsin (both highly sensitive), amylase (rarely expressed), BCL10 (highly sensitive and specific), and lipase (highly specific but low sensitivity).

Other positive markers that may be expressed: neuroendocrine markers (focally positive), hepatocellular carcinoma markers (AFP, Hep Par-1, glypican-3, albumin mRNA), nuclear expression of β-catenin (10% of cases), CK7, CK19, and PDX-1.

Image 9 of 26