Histological Evaluation of Preoperative Biopsies from Ampulla Vateri

Gábor ELEK1, Sándor GYŐRI1, Bernadett TÓTH1, Ákos PAP2

1Department of Pathology, Central Railway Hospital and Policlinic, Budapest, Hungary
2Department of Gastroenterology, Central Railway Hospital and Policlinic, Budapest, Hungary


Frequency of the lesions of the papilla Vateri is increasing in Hungary because of epidemiological reasons. Over two years nearly 300 ampullary endoscopic biopsies were taken in our hospital. In 36 percent of the patients the papillary specimens demonstrated acute or chronic inflammation, in 44 percent adenoma, including 5 percent with severe dysplasia, in 5 percent adenomatous hyperplasia and in 7 percent adenomyosis or other benign tumors (2%) were found. Around 7 percent of the ampullary samples proved to be malignant, but only in 2.6 percent were the malignancy of intraampullary origin. Nearly 25 percent of biopsies were repeated once and 10 percent twice or more. Concordance of endoscopic and pathologic diagnoses was 69 percent on average but it increased to 83 percent after including repeated biopsies. In the adenoma-carcinoma group the concordance was 90 percent. The sensitivity of the pathological diagnosis with forceps biopsy was only 77 percent, but it became at least 86 percent following papillectomy. In order to improve diagnostic reliability more extensive use of papillectomy is proposed with close cooperation between the endoscopist and pathologist. Pathology & Oncology Research, Vol 9, Nr 1, 32-41, 2003

Key words: papilla Vateri; preoperative diagnosis; sampling error; papillectomy; biopsy of Vater papilla; pathohistology; forceps biopsy

Received: Jan 16, 2003; accepted: Mar 30, 2003
Correspondence: Gábor ELEK, Department of Gastroenterology, Central Railway Hospital and Policlinic, Podmaniczky street 111 Budapest 1062, Hungary; E-mail:

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