Gassler N, Knüchel R
Institut für Pathologie, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Pathologe. 2012 Feb;33(1):17-23. doi: 10.1007/s00292-011-1546-8.
Tumors of Vater's ampulla are generally uncommon. In this location intestinal type adenomas are frequently found, followed by noninvasive papillary neoplasms of the pancreaticobiliary type and neuroendocrine tumors (carcinoids). Carcinomas of Vater's ampulla represent about 0.5% of all gastrointestinal malignancies. Intestinal type adenocarcinoma is the most common malignant epithelial tumor followed by the pancreaticobiliary type adenocarcinoma. Highly malignant neuroendocrine carcinomas of Vater's ampulla are very uncommon. Carcinomas of the ampullary region can be sporadic or a component of several disease syndromes. Designation of large carcinomas as tumors with an ampullary or extra-ampullary origin can be difficult but is of relevance for a TNM conform classification. Helpful in the decision are the relationship between the tumor centre and Vater's ampulla, the existence of premalignant lesions in the ampullary epithelium as well as histology and immunostaining of the tumor.
壶腹周围肿瘤通常并不常见。在此部位，常发现肠型腺瘤，其次是胰胆管型非侵袭性乳头状肿瘤和神经内分泌肿瘤（类癌）。壶腹周围癌约占所有胃肠道恶性肿瘤的0.5%。肠型腺癌是最常见的恶性上皮性肿瘤，其次是胰胆管型腺癌。壶腹周围高恶性神经内分泌癌非常罕见。壶腹区域的癌可以是散发性的，或是几种疾病综合征的组成部分。将大的癌瘤区分为起源于壶腹或壶腹外的肿瘤可能很困难，但对于符合TNM分类很重要。肿瘤中心与壶腹的关系、壶腹上皮中癌前病变的存在以及肿瘤的组织学和免疫染色有助于做出判断。
