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To Study the Spectrum of Histopathological Variants of Periampullary Carcinoma

Prasuna Chilveri Assistant Professor, Department of Pathology, Chalmeda Anandrao Institute of Medical Sciences, Bommakal, Karimnagar, Telangana 505001, India. , Prasuna Chilveri1 , Bhavani Adepu2 , Triveni Bhopal3

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Indian Journal of Pathology: Research and Practice 7(4):p 416-422, April 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7418.2

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Abstract

Introduction: Periampullary tumours are defined as those that arise within 2 cm of the major papilla in the duodenum. These tumors exhibit different morphology, immunohistochemistry patterns and different clinical behaviors based on the exact site of origin.

Aim of the study:To study the spectrum of histopathological variants of periampullary carcinoma.

Materials and Methods: This was a retrospective study conducted in Upgraded department of Pathology, Osmania Medical College and General Hospital, Hyderabad over a three year period. A total of 66 cases of periampullary carcinomas resected by Whipples procedure were studied. Histopathologic examination, staging and classification of tumorswas done based on site of origin as pancreatic, ampullary, distal common bile duct, and duodenal carcinomas. Immunohistochemistry for CK7, CK20, NSE, Chromogranin A, and Ki67 was done.

Results: The maximum number of patients were in the range of 41 - 50 years with male: female ratio of 1.6:1. Of the 41 pancreatic periampullary carcinomas, majority were adenocarcinomas (35 cases).Out of 13 ampullary carcinomas 08 were Intestinal type and 04 were Pancreaticobiliary type adenocarcinomas and 01 was neuroendocrine type. Of the 62 periampullary adenocarcinomas, 72.5%, 24.1% and 3.4% were well, moderate and poorly differentiated carcinomas respectively. Pathological TNM staging was done in 62 resected specimens. Majority of the pancreatic adenocarcinomas (24 cases) were StageIII.

Conclusion: A combination of tumor size, tumor site, histopathological type and grade, lymphnode involvement and status of resected margins all influence the overall survival of patients undergoing pancreaticoduodenectomy for periampullary carcinomas. Hence, it is important to classify these tumors according to these parameters.

Keywords: Periampullary Carcinoma; Anatomical Site; TNM Staging; Histopathologic Variants 

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DOI: DOI: http://dx.doi.org/10.21088/ijprp.2278.148X.7418.2

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