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Diagnostic Pearls and Pitfalls in the Evaluation of Small Biopsies From the Bile Duct and Ampulla
1From the Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta, Georgia.
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.
