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WHO Classification of Tumours
Adenocarcinoma, intestinal type
Region of the ampulla of Vater


A variant of adenocarcinoma arising from epithelium which has undergone intestinal metaplasia. It is histologically characterized by neoplastic tubular glands or papillary structures lined predominantly by cells with an intestinal phenotype, namely goblet cells or colonic-type epithelium or both, with or without a variable number of endocrine and Paneth cells
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Hamilton SR, Aaltonen LA (Eds.)
World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System.
3rd Edition
IARC Press: Lyon 2000


Intestinal-type adenocarcinoma of the ampulla of Vater
This type of invasive adenocarcinoma is the most common malignant epithelial tumour of the ampulla and consists of simple or cribriformed tubular glands similar to those of adenocarcinomas of the colon. The glands are lined predominantly by columnar cells with pseudostratified oval or elongated nuclei showing varying degrees of atypia and a variable number of mitotic figures. In some carcinomas, goblet cells are interspersed with the columnar cells. Rarely, Paneth cells and endocrine cells are also present. Dirty-type necrosis as seen in adenocarcinomas of the colon is not as common in ampullary intestinal-type adenocarcinomas. Most of these tumours are associated with an adenoma. Adenocarcinomas arising in adenomas are usually smaller and have a better prognosis than adenocarcinomas unrelated to adenomas.