Ampulla of Vater
Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 1 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.
● 3% of ampullary tumors
● Patients typically present with jaundice
● Compared to duodenal carcinoids (which are usually benign), are more aggressive with shorter survival (may die within 1 year), have more metastases
● Somatostatin producing tumors are common, have a glandular pattern, are associated with psammoma bodies and neurofibromatosis, have 50-70% nodal metastases (Am J Clin Pathol 1991;95:51, Am J Clin Pathol 1983;80:755, Am J Clin Pathol 1992;97:411, Am J Surg Pathol 1989;13:828)
● 52 year old Chinese woman with inflammatory pseudotumor associated with periampullary carcinoid
(Singapore Med J 2009;50:e100)
● Classic features of carcinoid tumors; somatostatin producing tumors are often mucin+
Monotonous tumor cells with small round nuclei plus various images
● Chromogranin (60%), synaptophysin (60%), gastrin (20% vs. 75% of duodenal carcinoids, Hum Pathol 2001;32:1252)
● Also somatostatin and pancreatic polypeptide
Arch Pathol Lab Med 2010;134:181-CAP protocol for examination of carcinoid tumors
End of Ampulla of Vater > Other malignancies > Carcinoid
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