Primary lymphoma of the ampulla of vater

• Published in: Cancer 1994-04, Vol.73 (8), p.2083-2086
• Main Authors: Pawade, Joya, Lee, Soon C., Ellis, David W., Vellar, Ivo D. A., Rode, Jurgen
• Format: Article
• Language: English
• Subjects: Ampulla of Vater; Ampulla of Vater - pathology; Biological and medical sciences; Cholestasis - diagnosis; Common Bile Duct Neoplasms - diagnosis; Common Bile Duct Neoplasms - pathology; Diagnosis, Differential; duodenal lymphoid hyperplasia; extra‐nodal lymphoma; Female; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, B-Cell - diagnosis; Lymphoma, B-Cell - pathology; Lymphoma, Non-Hodgkin - diagnosis; Lymphoma, Non-Hodgkin - pathology; Medical sciences; Middle Aged; mucosa‐associated lymphoid tissue (MALT); Staining and Labeling - methods
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19940415)73:8<2083::AID-CNCR2820730812>3.0.CO;2-B

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.