Primary lymphoma of the ampulla of Vater.
A 57-year-old woman was investigated for obstructive jaundice with endoscopic retrograde cholangiopancreaticography that showed a tumor at the ampulla of Vater. A Whipple's procedure was performed. A protuberant tumor was present at the ampulla of Vater in the background of multiple mucosal polyps in the duodenum. Light microscopy revealed a diffuse non-Hodgkin's lymphoma with centrocytelike cells forming lymphoepithelial lesions and infiltrating the sphincter of Oddi. The duodenal polyps were hyperplastic lymphoid follicles with reactive germinal centers. Immunohistochemical staining characterized the tumor as a B-cell neoplasm with IgA heavy-chain and lambda light-chain restrictions. Complete remission of the disease occurred after surgery. The clinical, histologic, and immunohistochemical features of this lymphoma are suggestive of histogenetic derivation from mucosal-associated tissue.
Pawade
J
J
Department of Anatomical Pathology, St. Vincent's Hospital, Melbourne, Australia.
Lee
C S
CS
Ellis
D W
DW
Vellar
I D
ID
Rode
J
J
D014670:Ampulla of Vater / Q000473:pathology*; D002779:Cholestasis / Q000175:diagnosis; D003138:Common Bile Duct Neoplasms / Q000175:diagnosis / Q000473:pathology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000473:pathology*; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis / Q000473:pathology*; D008875:Middle Aged; D013194:Staining and Labeling / Q000379:methods