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WHO Classification of Tumours
Papillary adenocarcinoma, NOS
Region of the ampulla of Vater


Exophytic neoplasms with a papillary architecture can occur in the ampulla, similar to those arising in the gallbladder and extrahepatic bile ducts. In the past, these neoplasms have been classified as noninvasive and invasive papillary carcinomas
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Albores-Saavedra J, Murakata L, Krueger JE, Henson DE (2000)
Noninvasive and minimally invasive papillary carcinomas of the extrahepatic bile ducts.
Cancer 89: 508-15

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Albores-Saavedra J, Tuck M, McLaren BK, Carrick KS, Henson DE (2005)
Papillary carcinomas of the gallbladder: analysis of noninvasive and invasive types.
Arch Pathol Lab Med 129: 905-9

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Hoang MP, Murakata LA, Katabi N, Henson DE, Albores-Saavedra J (2002)
Invasive papillary carcinomas of the extrahepatic bile ducts: a clinicopathologic and immunohistochemical study of 13 cases.
Mod Pathol 15: 1251-8

. Noninvasive lesions are now designated “noninvasive papillary neoplasms.” When an invasive carcinoma arises in association with a noninvasive papillary neoplasm, the invasive component should be diagnosed, graded, and staged separately from the noninvasive component.

Papillary adenocarcinoma of the ampulla of Vater
In the ampulla, most such invasive carcinomas are of pancreatobiliary or intestinal type. Only rarely does an invasive carcinoma maintain a papillary growth pattern in the invasive elements, and although a descriptive term of “invasive papillary carcinoma” could be used for these neoplasms, most can be more accurately classified on the basis of cellular differentiation and morphology as one of the other histological variants of ampullary carcinoma

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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010