Molecular Pathology of Carcinomas of the Ampullary/Periampullary Region

Reference work entry

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.

In recent times, crucial advances have been made in characterizing carcinomas of the ampullary/periampullary region on a molecular level. Several molecular patterns seem to correlate with prognosis. Moreover, some molecular pathways, e.g., the WNT pathway, represent potential therapeutic targets to be used in the context of personalized medicine in the future. Gene panel analysis is a promising approach that could be used to translate these findings into clinical applications.

Keywords

Periampullary cancer Ampullary cancer Duodenal cancer Distal bile duct cancer Precursor lesions Molecular pathology Next-generation sequencing NGS 

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute of PathologyHeinrich Heine University of DuesseldorfDuesseldorfGermany

Section editors and affiliations

  • Raul A. Urrutia
    • 1
  • Markus W. Büchler
    • 2
  • John Neoptolemos
    • 3
  1. 1.Mayo Clinic Cancer CenterMayo ClinicRochesterUSA
  2. 2.Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany
  3. 3.Division of Surgery and OncologyUniversity of LiverpoolLiverpoolUK

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