Difference between revisions of "Ampulla of Vater"
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The '''ampulla of Vater''', also '''hepatopancreatic ampulla, is found in the [[duodenum]]. It has a unique histology and is a relatively common site of disease. | The '''ampulla of Vater''', also '''hepatopancreatic ampulla''', is found in the [[duodenum]]. It has a unique histology and is a relatively common site of disease. | ||
=Normal histology= | =Normal histology= | ||
Revision as of 10:44, 16 October 2012
The ampulla of Vater, also hepatopancreatic ampulla, is found in the duodenum. It has a unique histology and is a relatively common site of disease.
Normal histology
Features:[1]
- Complex folding of epithelium - may for papillae.
- +/-Pancreatic heterotopia - common.
- +/-Gastric heterotopia - not common.
Ampullary tumours
Ampullary adenoma
General
- Uncommon.
- May be associated with familial adenomatous polyposis (FAP).
Microscopic
Features:
- +/-Paneth cells - may be prominent.[2]
- Similar to adenoma of colon - with:
- Less pseudostratification.
- Finer chromatin pattern.
DDx:
Sign out
- See tubular adenoma.
Ampullary adenocarcinoma
- AKA ampullary carcinoma.
General
- Uncommon.
- Textbook association: familial adenomatous polyposis.[3][4]
Microscopic
Features:
- Dependent on subtype.
Notes:
- May lack desmoplastic stroma.[2]
Main subtypes:[5]
- Intestinal ampullary carcinoma.
- Pancreatobiliary ampullary carcinoma.
DDx:
- Invasive ductal carcinoma of the pancreas.
- Ectopic pancreas.[6]
IHC
Features:[5]
- CK7 +ve.
- CK20 +ve.
- MUC2 +ve.
Sign out
- Separate CAP protocol.[7]
See also
References
- ↑ Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H (2009). Sternberg's Diagnostic Surgical Pathology (5th ed.). Lippincott Williams & Wilkins. pp. 1639. ISBN 978-0781779425.
- ↑ 2.0 2.1 Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Reuter, Victor E; Stoler, Mark H (2009). Sternberg's Diagnostic Surgical Pathology (5th ed.). Lippincott Williams & Wilkins. pp. 1640. ISBN 978-0781779425.
- ↑ Tran, TC.; Vitale, GC. (Dec 2004). "Ampullary tumors: endoscopic versus operative management.". Surg Innov 11 (4): 255-63. PMID 15756395.
- ↑ Soravia, C.; Berk, T.; Haber, G.; Cohen, Z.; Gallinger, S.. "Management of advanced duodenal polyposis in familial adenomatous polyposis.". J Gastrointest Surg 1 (5): 474-8. PMID 9834381.
- ↑ 5.0 5.1 Fischer, HP.; Zhou, H. (2004). "Pathogenesis of carcinoma of the papilla of Vater.". J Hepatobiliary Pancreat Surg 11 (5): 301-9. doi:10.1007/s00534-004-0898-3. PMID 15549428.
- ↑ Hsu, SD.; Chan, DC.; Hsieh, HF.; Chen, TW.; Yu, JC.; Chou, SJ. (Apr 2008). "Ectopic pancreas presenting as ampulla of Vater tumor.". Am J Surg 195 (4): 498-500. doi:10.1016/j.amjsurg.2007.01.043. PMID 18304504.
- ↑ URL: http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/Ampulla_12protocol_3101.pdf. Accessed on: 12 September 2012.