Ampulla of Vater
Normal histology

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

Revised: 22 January 2016, last major update November 2012

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

Table of Contents
Definition / general
Cite this page: Normal histology. website. Accessed October 16th, 2018.
Definition / general
  • Mucosa forms prominent papillary folds / reduplications resembling fallopian tubal fimbriae with fibrovascular cores
  • Lined by pancreaticobiliary-type ductal epithelium with occasional goblet cells, no absorptive-type cells
  • Lamina propria has only occasional lymphocytes, plasma cells and mast cells
  • May have adjacent pancreatic acini, but usually no islets around major papillae
  • Common bile duct can be distinguished from main pancreatic (Wirsung) duct by its larger size, more prominent folds, thicker musculature, intraluminal bile
  • Ampullary biopsy performed in autoimmune pancreatitis can help to differentiate from other "mass forming" pancreatitis by IgG4+ to IgG+ ratio (Am J Surg Pathol 2008;32:1770)