Diagnostic Pearls and Pitfalls in the Evaluation of Small Biopsies From the Bile Duct and Ampulla.

Publisher: College of American Pathologists Country of Publication: United States NLM ID: 7607091 Publication Model: Print Cited Medium: Internet ISSN: 1543-2165 (Electronic) Linking ISSN: 00039985 NLM ISO Abbreviation: Arch Pathol Lab Med Subsets: MEDLINE

Publication: Northfield, Ill. : College of American Pathologists
Original Publication: Chicago, American Medical Assn.

Ampulla of Vater*/pathology ; Bile Ducts*/pathology ; Bile Duct Neoplasms*/diagnosis ; Bile Duct Neoplasms*/pathology ; Common Bile Duct Neoplasms*/diagnosis ; Common Bile Duct Neoplasms*/pathology; Humans ; Biopsy/methods ; Diagnosis, Differential

Competing Interests: The author has no relevant financial interest in the products or companies described in this article.
Context.—: Histopathologic evaluation of bile duct and ampullary biopsies can be challenging. Biopsies from these sites are often tiny, scant, and/or fragmented. When assessing these biopsies, there is significant overlap between reactive atypia and malignancy, in situ precursor lesions can be misinterpreted as malignancy, and nonprimary tumors can mimic primary disease.
Objective.—: To provide diagnostic pearls and pitfalls in the evaluation of small biopsies from the biliary tract.
Data Sources.—: Literature review of published studies and the author's own observations.
Conclusions.—: Because the procedures for obtaining specimens from the bile duct and ampulla are invasive, pathologists need to try to make definitive diagnoses. Diagnostic clues/pearls, ancillary studies, and recognition of various pitfalls can assist in providing accurate and confident diagnoses.
(© 2025 College of American Pathologists.)

Date Created: 20241127 Date Completed: 20250224 Latest Revision: 20250426

20250428

10.5858/arpa.2024-0160-RA

39603257