Specimen: Ampulla of Vater

Other organs received:
   Stomach
   Head of pancreas
   Duodenum
   Common bile duct
   Gallbladder
   Other (specify):
   Not specified

Procedure:
Ampullectomy
Pancreaticoduodenectomy (Whipple resection)
Other (specify):
Not specified

Tumor Site:
Intra-ampullary
Peri-ampullary
Papilla of Vater (junction of ampullary and duodenal mucosa)
Other (specify):
Cannot be determined
Not specified

Tumor Size:
   Greatest dimension: cm
   Additional dimensions: cm
   Cannot be determined (see Comment)

Histologic Type:
Adenocarcinoma (not otherwise characterized)
Papillary adenocarcinoma
Adenocarcinoma, intestinal type
Mucinous adenocarcinoma
Clear cell adenocarcinoma
Signet-ring cell carcinoma
Adenosquamous carcinoma
Squamous cell carcinoma
Small cell carcinoma
Other (specify):
Carcinoma, not otherwise specified

Histologic Grade:
Not applicable (histologic type not usually graded)
GX: Cannot be assessed
G1: Well differentiated
G2: Moderately differentiated
G3: Poorly differentiated
G4: Undifferentiated
Other (specify):

Microscopic Tumor Extension:
   Cannot be assessed
   No evidence of primary tumor
   Carcinoma in situ
   Tumor limited to ampulla of Vater or sphincter of Oddi
   Tumor invades duodenal wall
   Tumor invades pancreas
   Tumor invades peripancreatic soft tissues
   Tumor invades extrapancreatic common bile duct
   Tumor invades other adjacent organs or structures other than pancreas:

Margins:
   Ampullectomy Specimen:
    Cannot be assessed
    Margins uninvolved by invasive carcinoma, distance of invasive carcinoma from closest margin: mm at
    Margins involved by invasive carcinoma:
    Not applicable
   Pancreaticoduodenal Resection Specimen:
       Proximal Mucosal Margin (Gastric or Duodenal):
        Cannot be assessed
        Uninvolved by invasive carcinoma
        Involved by invasive carcinoma
        Intramucosal carcinoma /adenoma not identified at proximal margin
        Intramucosal carcinoma/adenoma present at proximal margin
       Distal Margin (Distal Duodenal or Jejunal):
        Cannot be assessed
        Uninvolved by invasive carcinoma
        Involved by invasive carcinoma
        Intramucosal carcinoma/adenoma not identified at distal margin
        Intramucosal carcinoma /adenoma present at distal margin
       Pancreatic Retroperitoneal (Uncinate) Margin:
        Not applicable
        Cannot be assessed
        Uninvolved by invasive carcinoma
        Involved by invasive carcinoma (tumor present 0-1 mm from margin)
       Bile Duct Margin:
        Not applicable
        Cannot be assessed
        Margin uninvolved by invasive carcinoma
        Margin involved by invasive carcinoma
       Distal Pancreatic Resection Margin:
        Not applicable
        Cannot be assessed
        Margin uninvolved by invasive carcinoma
        Margin involved by invasive carcinoma

Distance of invasive carcinoma from closest margin: at

Lymph-Vascular Invasion:
Not identified
Present
Indeterminate

Perineural Invasion:
    Not identified
    Present
    Indeterminate

Pathologic Staging (pTNM) (Note F)

TNM Descriptors:
       m (multiple primary tumors)
       r (recurrent)
       y (post-treatment)

Primary Tumor (pT):
pTX: Cannot be assessed
pT0: No evidence of primary tumor
pTis: Carcinoma in situ
pT1: Tumor limited to ampulla of Vater or sphincter of Oddi
pT2: Tumor invades duodenal wall
pT3: Tumor invades pancreas
pT4: Tumor invades peripancreatic soft tissues or other adjacent organs or structures

Regional Lymph Nodes (pN):
pNX: Cannot be assessed
pN0: No regional lymph node metastasis ( 0 / )
pN1: Regional lymph node metastasis ( / )
No nodes submitted or found

Distant Metastasis (pM):
    Not applicable
    pM1: Distant metastasis at

Additional Pathologic Findings:
       None identified
       Dysplasia/adenoma
       Other (specify):

Ancillary Studies:

Clinical History:
       Familial adenomatous polyposis coli
       Other (specify):
       Not known

Comment(s):