Nakao N L, Siegel J H, Stenger R J, Gelb A M
Gastroenterology. 1982 Aug;83(2):459-64.
In 2 cases of ampullary tumor, the diagnosis was made by intraampullary biopsy after an abnormality was discovered via the fluoroscope during endoscopic retrograde cholangiopancreatography. One case was a villotubular adenoma with dysplasia and carcinoma in situ, and the other, a polypoid adenocarcinoma of the ampulla of Vater. These tumors were not visualized on upper gastrointestinal barium studies and conventional duodenoscopy nor by direct vision during endoscopic retrograde cholangiopancreatography. In the past the diagnosis of ampullary neoplasm has been most often made of surgery and on autopsy. Only in 11 of 538 patients reviewed was the diagnosis made by biopsy of a tumor visible at endoscopy. As demonstrated by the two cases we report, intraampullary biopsy of lesions visualized on fluoroscopy during endoscopic retrograde cholangiopancreatography may facilitate early diagnosis.
在2例壶腹肿瘤中，在内镜逆行胰胆管造影术（ERCP）期间通过荧光镜发现异常后，经壶腹内活检做出诊断。1例为伴有发育异常和原位癌的绒毛管状腺瘤，另1例为 Vater 壶腹息肉样腺癌。这些肿瘤在上消化道钡餐检查、传统十二指肠镜检查以及ERCP直视下均未显影。过去，壶腹肿瘤的诊断大多依靠手术及尸检。在回顾的538例患者中，仅11例通过对内镜可见肿瘤进行活检做出诊断。正如我们报告的这2例所示，在内镜逆行胰胆管造影术期间对荧光镜下可见病变进行壶腹内活检可能有助于早期诊断。
