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Difference between revisions of "Ampulla of Vater"
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#Pancreaticobiliary ampullary carcinoma. | #Pancreaticobiliary ampullary carcinoma. | ||
#Other. | #Other. | ||
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[[File:1 amp ca 1 680x512px.tif|Invasive carcinoma of duodenal ampulla.]] | |||
[[File:2 amp ca 1 680x512px.tif|Invasive carcinoma of duodenal ampulla.]] | |||
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[[File:3 amp ca 1 680x512px.tif|Invasive carcinoma of duodenal ampulla.]] | |||
[[File:4 amp ca 1 680x512px.tif|Invasive carcinoma of duodenal ampulla.]] | |||
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[[File:5 amp ca 1 680x512px.tif|Invasive carcinoma of duodenal ampulla.]] | |||
[[File:6 amp ca 1 680x512px.tif|Invasive carcinoma of duodenal ampulla.]] | |||
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Invasive carcinoma of duodenal ampulla, intestinal type. A. Ulceration tops Brunner’s glands [green arrow]; at the edge lie glands [blue arrow] with changes suggesting adenoma (100X). B. Ki67 stain establishes adenoma by surface extension of brown nuclei (100X). C. The lesion was a mass, prompting rebiopsy. The cauterized fragment shows disorderly spread of glands, with dilated glands at base [arrows] not readily explained by obstruction (40X) D.Two cancerous prongs, one on left [black arrow], one on right [blue arrow] each show spread about muscle fibers (200X). E. The Whipple resection showed the same dilated spreading glands [arrows] at base, redolent of the spread of some well-differentiated colonic adenocarcinomas through muscle (40X). F. Cribriformed cancerous nests [arrows] cannot be Brunner’s glands, because the nuclei are too variable and lack polarity and because they abut crypts extending to the surface; cautery would have made this an impossible distinction (200X). | |||
Notes: | Notes: | ||