Molecular Pathology of Carcinomas of the Ampullary/Periampullary Region

Abstract

The ampullary/periampullary region is a complex anatomical environment giving rise to a number of heterogeneous malignancies. Ampullary carcinomas should be distinguished from periampullary duodenal, biliary, and pancreatic adenocarcinomas. A meticulous classification of periampullary/ampullary carcinomas is of great importance, as the biological behavior of the various types of carcinomas differs significantly, affecting their prognosis and therefore their clinical management. Subtypes of ampullary carcinomas, namely, intra-ampullary, ampullary ductal, periampullary duodenal, and ampullary NOS (not otherwise specified) carcinomas, have been recently proposed based on a detailed assessment of their gross appearance in correlation with microscopic findings. Moreover, ampullary carcinomas can be further classified as intestinal type, pancreatobiliary type, or mixed type based on the tumor’s histomorphology and immunohistochemical profile.