Ampulla of Vater
Features to report

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

Revised: 24 February 2016, last major update December 2012

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

Table of Contents
Definition / General
Cite this page: Features to report. website. Accessed October 22nd, 2016.
Definition / General

Items listed below are mandatory to report for accreditation purposes by American College of Surgeons Committee on Cancer, except those in italics, which are optional but still recommended

  • Specimen type
  • Tumor site
  • Presumed tumor origin (intraampullary, periampullary duodenum, mixed, common bile duct, pancreatic)
  • Histologic type
  • Histologic grade (well, moderate, poor or undifferentiated)
  • Tumor size (invasive carcinoma component)
  • Depth of invasion, local extension
  • Margins - invasive carcinoma; distance to closest margin and identify margin (recommended to ink posterior retroperitoneal surface of pancreas and submit sections of tumor closest to this margin)
  • Margins - carcinoma in situ; involvement of pancreatic duct or common bile duct margin
  • Margins - PanIn
  • Pathologic staging
  • Perineural invasion (for resections)
  • Angiolymphatic invasion (for resections)
  • Lymph nodes
  • Additional findings: PanIN / dysplasia, adenoma, inflammation, adenomyosis, pancreatitis, gastritis, other