Ampulla of Vater
Benign/non-neoplastic
Adenomyoma

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 22 January 2016, last major update December 2012

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: Adenomyoma
General
  • Also called adenomyomatous hyperplasia
  • Rare, benign
  • Usually stomach, duodenum, jejunum
  • Often causes pain in right upper quadrant, radiating to back
  • May cause biliary obstruction and common bile duct dilation (Arch Pathol Lab Med 1987;111:388)
Case Reports
Treatment
  • Excision
Gross Description
  • Mass at head of pancreas, usually 0.5 cm or more
Micro Description
  • Well circumscribed, nodular proliferation of smooth muscle cells, ducts and glands, clearly disorganized compared to normal
  • Ducts and glands are lined by columnar/cuboidal cells
  • No atypia, no mitoses, usually no pancreatic tissue
Micro Images

Benign ducts with whorled smooth muscle stroma

Positive Stains
Negative Stains
  • MUC1, MUC4
Differential Diagnosis
  • Normal intraampullary common bile duct (normally has dense muscular layer)
  • Ectopic pancreatic tissue
  • Fibroadenoma
  • Brunner gland hyperplasia