[Carcinoma of the pancreas: pathologic anatomy (author's transl)].

Carcinoma of the pancreas is seen in 1.2 percent of autopsies. Often it is not possible to determine definitely: whether it is a carcinoma of the head of the pancreas, of the papilla, or of the distal part of the common bile duct (periampullary carcinoma). 90 percent of these carcinomas arise in the small ducts. They cannot be recognized by ERCP until spreading into the main duct has occurred. Differential diagnosis is concerned mainly with differentiating between chronic pancreatitis and carcinoma of the pancreas. Chronic pancreatitis and carcinoma of pancreas are not mutually exclusive; on the contrary they are closely related in diagnosis and pathogenesis. There can be no carcinoma of the pancreas without pancreatitis. For an accurate diagnosis which is vital, a diagnostic laparotomy should be performed at an early stage.