Carcinoma of Ampulla of Vater: Carcinogenesis and Immunophenotypic Evaluation

The ampulla of Vater represents the epithelial junction of the main pancreatic duct and the distal bile duct, surrounded by the pancreatic head and duodenum parenchyma. Ampullary carcinoma can arise either from the intestinal epithelium or the epithelium covering the pancreatobiliary ducts. Many tumors develop from pre-existing adenomas, others evolve from precursor intraepithelial neoplasia supporting that two histological subtypes have different carcinogenesis. Thus, the question arises of classifying ampullary adenocarcinomas as the immunophenotypic pattern allowing a better understanding of the clinical implications of this neoplasm.