Abstract

The papilla of Vater is a cylindrical protuberance that houses a common channel or the terminations of the common bile duct and main pancreatic duct. In cases of pancreaticobil-iary maljunction, the papilla of Vater, especially the plica longitudinalis, is slightly raised and has a longer slope, because it houses only the long common channel. The projecting papilla is covered with a circumscribed zone of mucous membrane that differs sharply from that of the surrounding mucosa. Glands near the surface of the papilla may be distended, are described as distended glands and also termed adenomatoid hyperplasia. Distended glands of the ampullary mucosa were frequently found, replacing the surrounding duodenal mucosa, and measured on average 1,532 ^m. The distended glands are found on Oddi's sphincter muscle and not on the muscularis mucosa of the duodenum. Immunohistochemically, the distended glands were negative or weakly positive for CA19-9, and showed 19.6 ± 21.0% on average for Ki67LI, while the level was 9.0 ± 11.0% in the intrapapillary glands, without a significant difference. Therefore, such glands might be not only related to malignant changes, but also a kind of adaptive phenomenon against bile and pancreatic juice flow.

Copyright © 2007 S. Karger AG, Basel

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