Ampullary region carcinomas: definition and site specific classification with delineation of four clinicopathologically and prognostically distinct subsets in an analysis of 249 cases

The American Journal of Surgical Pathology
Volkan AdsayMichael Goodman

Abstract

Ampullary (AMP) carcinomas comprise a heterogeneous group of cancers lacking adequate subcategorization. In the present study, 249 strictly defined primary AMP carcinomas (ACs) identified in 1469 malignant pancreatoduodenectomy specimens were analyzed for defining features. Gross and microscopic findings were used to determine tumor epicenter and extent of preinvasive component. ACs were classified into 4 distinct subtypes based on location: (1) Intra-AMP (25%): Invasive carcinomas arising in intra-ampullary papillary-tubular neoplasms with zero to minimal, duodenal surface involvement (<25% of the tumor). These tumors were more commonly found in men, they had a relatively large overall size (mean, 2.9 cm) but had smaller invasive component (mean, 1.5 cm), and were predominantly of a lower TNM stage (85%, T1/2; and 72% N0). They carried the best prognosis among the 4 groups (3-y survival, 73%). (2) AMP-ductal (15%): These were tumors forming constrictive, sclerotic, plaque-like thickening of the walls of the common bile duct and/or pancreatic duct resulting in mucosa-covered, button-like elevations of the papilla into the duodenal lumen. There was no significant exophytic (preinvasive) growth. These were the smallest tumors (me...Continue Reading

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Citations

Jul 31, 2014·Archives of Pathology & Laboratory Medicine·DongDo YouKee-Taek Jang
May 16, 2015·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Jaclyn F HechtmanDavid S Klimstra
Jul 1, 2015·Archives of Pathology & Laboratory Medicine·Jacob R BledsoeVikram Deshpande
Jun 2, 2015·Archives of Pathology & Laboratory Medicine·Stephen LaganaHelen Remotti
Apr 30, 2016·Archives of Pathology & Laboratory Medicine·Kee-Taek Jang, Sangjeong Ahn
Oct 28, 2016·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Raul S GonzalezN Volkan Adsay
Sep 3, 2016·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Michelle D ReidVolkan Adsay
Jan 6, 2017·Archives of Pathology & Laboratory Medicine·Michelle D ReidN Volkan Adsay
May 30, 2017·International Journal of Surgical Pathology·Shyam Sunder MahansariaTushar Kanti Chattopadhyay
May 16, 2017·Histopathology·Deborah SaraggiMassimo Rugge
Dec 18, 2013·Journal of Surgical Oncology·Walid L ShaibBassel F El-Rayes
Jan 25, 2014·Histopathology·Iraklis PerysinakisGregory Kouraklis
Oct 16, 2019·International Journal of Surgical Pathology·Deniz TuncelVolkan Adsay
Jul 1, 2019·Journal of Clinical Pathology·Mads Rohde HarthimmerSönke Detlefsen
Feb 13, 2018·Molecular and Clinical Oncology·Francesca SarocchiCord Langner
Aug 18, 2016·Surgical Endoscopy·María-Victoria Alvarez-SanchezBertrand Napoléon
Oct 16, 2016·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Yue XueVolkan Adsay
Jun 1, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Alain SauvanetMaxime Palazzo
Jun 9, 2018·United European Gastroenterology Journal·Kwang Hyun ChungYong-Tae Kim
Aug 10, 2018·Virchows Archiv : an International Journal of Pathology·Munita BalShailesh Shrikhande
Oct 2, 2019·Diagnostics·Jiaqi Shi, Olca Basturk
Jan 4, 2019·Cancer Immunology, Immunotherapy : CII·Min Hwan KimHye Jin Choi
May 8, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·João Paulo Lemos da Silveira SantosVivian Resende
Jul 13, 2018·Virchows Archiv : an International Journal of Pathology·Aoife Maguire, Kieran Sheahan
Nov 30, 2018·World Journal of Gastrointestinal Oncology·Antonio PeaClaudio Luchini

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