FIGURES AND TABLES

FIGURE 1.

Intramural protruding form. The tumor cells proliferate in a papillary fashion and are restricted to within the muscle of Oddi. We define this tumor as an early ampullary carcinoma (hematoxylin and eosin staining, 10 ).

FIGURE 2.

Exposed protruding form. Papillary proliferation of the tumor cells in the common channel extends to the surface of the ampulla of Vater (hematoxylin and eosin staining, 3 ). This case is also included in the category of early ampullary carcinoma.

FIGURE 3.

Ulcerating form. The carcinoma cells have invaded the duodenal wall and pancreatic parenchyma, indicating advanced ampullary carcinoma (hematoxylin and eosin staining, 3 ).

FIGURE 4.

a, Exposed protruding form of ampullary carcinoma. The papillary tumor proliferates in the common channel, on the surface of duodenal papilla, and within the intraduodenal common bile duct (hematoxylin and eosin staining, 3 ). b, Distribution of carcinomatous and adenomatous areas: the adenomatous areas are mostly present within the rim of the tumor and in the deep portion of the common channel and the common bile duct. c, Carcinomatous areas: tumor cells having bizarre nuclei and prominent nucleoli exhibit irregular tubules (hematoxylin and eosin staining, 160 ). d, Adenomatous areas: the epithelium proliferates in a tubular or villous fashion, and epithelial cells have moderate to severe nuclear atypia (hematoxylin and eosin staining, 120 ). e, p53 immunohistochemical stain in carcinomatous areas: in this case, carcinoma cells exhibit diffusely positive reaction in their nuclei (2+; 120 ). f, p53 immunohistochemical stain in adenomatous areas: tumor cells are diffusely positive (2+; 160 ). g, 60.5% of the tumor cells are positive for Ki-67 (120 ).

TABLE 1 - Prognostic Factors in 198 Patients with Carcinoma of the Ampulla of Vater.

TABLE 2 - Prognostic Factors in 198 Patients with Carcinoma of the Ampulla of Vater.

TABLE 3 - p53 Immunohistochemical Staining for Adenoma and Carcinoma with/without Adenomatous Areas.

TABLE 4 - Clinicopathological Factors and Immunohistochemical Staining in TNM Stage of the Ampulla of Vater.