Papillary hyperplasia of the ampulla of Vater

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  • 十二指腸乳頭部Papillary hyperplasiaの1例

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Abstract

A 67-year-old woman was found to have dilatation of the extrahepatic bile duct by ultrasonography, during ambulant treatment of hyperlipidemia. Enhanced computed tomography demonstrated mild thickness of the lower bile duct wall. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiography revealed dilatation of the extrahepatic bile duct with a non-enhanced area of the ampulla of Vater. A low-echoic lesion was observed in the bile duct portion of the ampulla of Vater by endoscopic ultrasonography, and the lesion also extended to the inferior bile duct. It was suspected that there was focal invasion to the pancreatic portion of the ampulla of Vater. No apparent malignancy was detected in the biopsy specimen. However, the possibility of a malignant tumor could not be completely excluded. Therefore, we performed pylorus-preserving pancreatoduodenectomy. Static and infected bile juice spouted from the dilated bile duct at resection. Macroscopically, the lumen of a portion of the bile duct of the ampulla of Vater was partially occluded by a papillary lesion. Microscopic examination showed that the epithelium of the papilla was lined by a single layer of columnar epithelial cells, accompanied by chronic inflammatory infiltrate in the lamina propria. Based on these findings, we diagnosed Papillary hyperplasia of the ampulla of Vater.<br>

Journal

  • Tando

    Tando 25 (4), 688-693, 2011

    Japan Biliary Association

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