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

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