Different Clinicopathologic Findings in Two Histologic Types of Carcinoma of Papilla of Vater

Abstract

The aim of this study was to investigate the differences between the clinicopathological findings in two histologic types of carcinoma of the papilla of Vater. We histologically classified carcinoma of the papilla into two types: 1) an intestinal type that resembles tubular adenocarcinoma of the stomach or colon, and 2) a pancreaticobiliary type that is characterized by papillary projections with scant fibrous cores. We examined 53 cases of resected carcinoma of the papilla. The intestinal‐type carcinomas were similar to the intestinal mucosa in that they had lysozyme‐containing, Paneth or argyrophil cells, as demonstrated by the immunohistochemically positive stainings for the anti‐lysozyme antibody. Although both the sizes of the two types of carcinomas and the age distributions of cases with the two types of carcinoma were almost the same, the prognosis of the cases with the intestinal type was much better than that of the cases with the pancreaticobiliary type. Histological lymph node metastasis was found significantly more often in the pancreaticobiliary type. This result was supported by the fact that small carcinomas of the intestinal type showed little or no invasion into the surrounding interstitium, as opposed to the pancreaticobiliary type, which had a strong infiltrative tendency. The pathogenesis of carcinoma of the papilla of Vater should be further evaluated, taking into consideration the existence of these two histologic types.

Prognostic significance of CDX2 and mucin expression in small intestinal adenocarcinoma

“…43 Intestinal adenocarcinomas consist of simple or cribriform tubular glands that are lined by tall columnar cells with pseudostratified nuclei (similar to colonic adenocarcinomas), whereas pancreatobiliary adenocarcinomas are composed of simple or branching glands that are lined by a single layer of cuboidal or columnar cells with abundant desmoplastic stroma. Similar observations have been reported for pancreatic ductal adenocarcinomas and extrahepatic cholangiocarcinomas.…”

Prognostic factors for ampullary adenocarcinomas: tumor stage, tumor histology, tumor location, immunohistochemistry and microsatellite instability

“…Currently, conflicting data have been reported about the frequency of the two major histological types of ACs (intestinal and BP type) due to the absence of reliable histomorphological or immunohistochemical markers for differential diagnosis [2,20,31]. Very recently, Hansel et al [18] examined a large series of ACs demonstrating that CDX2 expression alone may identify intestinal-type tumors with good prognosis, suggesting that it may be used as an independent marker of outcome at this site.…”

“…There are different histological classifications of ampullary carcinomas (ACs) which [2,3,20] makes comparison of clinical, therapeutic, and prognostic studies of these tumors difficult. So far, two major histological types of these tumors have been recognized: an intestinal type, arising from intestinal mucosa of the papilla, and a biliopancreatic (BP) type, deriving from the BP ductal epithelium.…”

“…So far, two major histological types of these tumors have been recognized: an intestinal type, arising from intestinal mucosa of the papilla, and a biliopancreatic (BP) type, deriving from the BP ductal epithelium. Nevertheless, conflicting data have been reported about the frequency of these two histological types due to the absence of reliable and consistent histomorphological criteria for differential diagnosis [2,20,31]. As patients with intestinal-type ampullary ACs have been reported to have a significantly better prognosis than patients with BP-type ACs [2,20], the clear differentiation between the two tumor types would have clinical implications.…”

MicroRNA expression profiles associated with pancreatic adenocarcinoma and ampullary adenocarcinoma

“…Conflicting data have been reported about the frequency of these two histological types due to the absence of reliable and consistent histomorphological criteria for differential diagnosis. [6][7][8][9] MicroRNAs are 19-25-nucleotide-long non-coding RNAs which after cleavage of a precursor into their mature form bind to the RNA-inducedsilencing-complex (RISC) and regulate gene expression posttranscriptionally by a binding of specific mRNA. MicroRNAs regulate many genes known to play important roles in oncogenesis, angiogenesis and tissue differentiation.…”