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Tumoren der Papilla Vateri

Tumors of Vater’s ampulla

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Zusammenfassung

Tumoren der Papilla Vateri sind insgesamt selten. Am häufigsten sind in dieser Lokalisation Adenome mit intestinaler Differenzierung, gefolgt von nichtinvasiven papillären Neoplasien vom pankreatikobiliären Typ und den neuroendokrinen Tumoren (Karzinoiden). Die Häufigkeit von Papillenkarzinomen ist mit etwa 0,5% aller gastrointestinalen malignen Tumoren sehr gering. Hier überwiegen Adenokarzinome vom intestinalen Typ, gefolgt vom pankreatikobiliären Typ. Die hoch malignen neuroendokrinen Karzinome der Papille sind sehr selten. Ampullenkarzinome können sporadisch auftreten oder auch Bestandteil verschiedener syndromaler Erkrankungen sein. Die TNM-relevante Abgrenzung echter Ampullenkarzinome von fortgeschrittenen Karzinomen der Duodenalschleimhaut, des distalen Gallen- bzw. Pankreasgangs oder des Pankreaskopfs kann problematisch sein. Neben histologischen und immunphänotypischen Kriterien sind für die korrekte Klassifikation der topographische Bezug des Tumorzentrums zur Papilla Vateri und der Nachweis präkanzeröser Läsionen im Papillenepithel wegweisend.

Abstract

Tumors of Vater’s ampulla are generally uncommon. In this location intestinal type adenomas are frequently found, followed by noninvasive papillary neoplasms of the pancreaticobiliary type and neuroendocrine tumors (carcinoids). Carcinomas of Vater’s ampulla represent about 0.5% of all gastrointestinal malignancies. Intestinal type adenocarcinoma is the most common malignant epithelial tumor followed by the pancreaticobiliary type adenocarcinoma. Highly malignant neuroendocrine carcinomas of Vater’s ampulla are very uncommon. Carcinomas of the ampullary region can be sporadic or a component of several disease syndromes. Designation of large carcinomas as tumors with an ampullary or extra-ampullary origin can be difficult but is of relevance for a TNM conform classification. Helpful in the decision are the relationship between the tumor centre and Vater’s ampulla, the existence of premalignant lesions in the ampullary epithelium as well as histology and immunostaining of the tumor.

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  1. Institut für Pathologie, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Deutschland

    N. Gaßler M.A. & R. Knüchel

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  1. N. Gaßler M.A.
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  2. R. Knüchel
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Correspondence to N. Gaßler M.A..

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Gaßler, N., Knüchel, R. Tumoren der Papilla Vateri. Pathologe 33, 17–23 (2012). https://doi.org/10.1007/s00292-011-1546-8

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