title: Diagnostic Accuracy of the Initial Endoscopy for Ampullary Tumors.
abstract: OBJECTIVE
  Ampullary tumors come in a wide variety of malignant forms. We evaluated the diagnostic accuracy of endoscopy for ampullary tumors, and analyzed the causes of misdiagnosis.
  
  
  METHODS
  We compared endoscopic imaging and biopsy results to final diagnoses. Types of endoscope, numbers of biopsy specimens taken, and final diagnoses were evaluated as possible factors influencing diagnostic accuracy.
  
  
  RESULTS
  Final diagnoses were 19 adenocarcinomas, 18 normal or papillitis, 11 adenomas, two adenomyomas, one paraganglioma, and one neuroendocrine tumor. The diagnostic accuracy of endoscopic imaging or the initial biopsy was identical (67.3%). At least one test was concordant with the final diagnosis in all except two cases. Compared with the final diagnosis, endoscopic imaging tended to show more advanced tumors, whereas the initial biopsy revealed less advanced lesions. The diagnostic accuracy of the initial biopsy was influenced by the type of endoscope used and the final diagnosis, but not by the number of biopsies taken.
  
  
  CONCLUSIONS
  Endoscopy has limited accuracy in the diagnosis of ampullary tumors. However, most cases with concordant endoscopic imaging and biopsy results are identical to the final diagnosis. Therefore, in cases where both of these tests disagree, re-evaluation with a side-viewing endoscope after resolution of papillitis is required.
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Hee Seung
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Jong Soon
authors.initials: JS
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Seungho
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Myeong Ho
authors.initials: MH
authors.lastname: Yeon
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Jae Geun
authors.initials: JG
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Joung-Ho
authors.initials: JH
authors.lastname: Han
authors.affiliation: Department of Pathology, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Rohyun
authors.initials: R
authors.lastname: Sung
authors.affiliation: Department of Internal Medicine, Medical Research Institute, Chungbuk National University College of Medicine, Cheongju, Korea.
authors.forename: Seon Mee
authors.initials: SM
authors.lastname: Park
keywords: Diagnostic accuracy; Endoscopic examination; Papillary tumors