Surgical Pathology Cancer Case Summary

AMPULLA OF VATER:             Report

AMPULLA OF VATER: Cytology/Biopsy

MACROSCOPIC (check all that apply)

SPECIMEN TYPE

___ Cytology

___ Incisional biopsy

___ Ampullectomy

TUMOR SITE

___ Intra-ampullary

___ Peri-ampullary

___ Junction of ampullary and duodenal mucosa

___ Unknown

MICROSCOPIC (check all that apply)

HISTOLOGIC TYPE

___ Carcinoma in situ

___ Papillary adenocarcinoma

___ Adenocarcinoma, intestinal type

___ Adenosquamous carcinoma

___ Other: __________________

HISTOLOGIC GRADE

___ GX: Cannot be assessed

___ G1: Well differentiated (>95% gland forming)

___ G2: Moderately differentiated (50-95% gland forming)

___ G3: Poorly differentiated (5-49% gland forming)

___ G4: Undifferentiated (<5% gland forming)

TUMOR SIZE (excisional biopsy only): ___ cm

EXTENT OF INVASION

___ Cannot be determined

___ Tis: Epithelium only (carcinoma in situ)

___ Lamina propria

___ T1: Tumor limited to ampulla of Vater or sphincter of Oddi (ampullectomy only)

___ T2: Tumor invades duodenal wall (ampullectomy only)

MARGIN

___ Uninvolved by tumor (ampullectomy only)

___ Not applicable

___ Involved by tumor (ampullectomy only)

ADDITIONAL PATHOLOGIC FINDINGS

___ None identified

___ Dysplasia/adenoma

___ Ampullitis

___ Adenomyosis

___ Other (specify: ____________________)

COMMENT

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