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CLASSIFICATION
Classification
JSBS macroscopic types (ampullary carcinoma)
Macroscopic types of ampillary carcinoma per the Japanese Society of Biliary Surgery General Rules: protruding, ulcerative, mixed, and others (normal, polypoid, special). Record on endoscopy before biopsy and staging.
Classification overview
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Main types
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腫瘤型 · Protruding type
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潰瘍型 · Ulcerative type
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混在型 · Mixed type
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Others
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正常型 · Normal-appearing papilla
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ポリープ型 · Polypoid type
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特殊型 · Special type
Main types
腫瘤型
Protruding type
Endoscopy
Protruding mass at the papilla without predominant ulceration
Note
Strongly suspicious for ampullary neoplasm; biopsy recommended
潰瘍型
Ulcerative type
Endoscopy
Ulcerative lesion at or around the papilla
Note
Includes protrusion with apical ulcer in clinical reports
混在型
Mixed type
Endoscopy
Combined protruded and ulcerative features
Note
Predominant protruded or ulcerative component is recorded when needed
Others
正常型
Normal-appearing papilla
Endoscopy
Papilla appears normal on endoscopy
Work-up
Endoscopic papillotomy may be needed before biopsy (JSCO 2015)
Note: Tumor may be non-exposed; papillotomy may be needed before biopsy.
ポリープ型
Polypoid type
Endoscopy
Polypoid lesion of the papilla
Morphology
May be exposed into the duodenal lumen or non-exposed with intraductal growth
Note: May be exposed into the lumen or non-exposed with intraductal growth.
特殊型
Special type
Definition
Macroscopic pattern not fitting the above categories
JSCO 2015, Original
Reference
Japanese reference
日本胆道外科学会. 胆道癌取扱い規約 第6版. 2013
Guideline / criteria
Nakamura M, et al. J Hepatobiliary Pancreat Sci. 2019;26:9-32
Related tools
Uchiyama ME-NBI classification (ampulla)
Ampullary ME-NBI
CLASSIFICATION
Uchiyama ME-NBI
→
Spigelman classification (FAP duodenal adenomas)
FAP adenoma (papilla assessed separately)
SCORE
Spigelman
→
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Decision support only. Follow current guidelines and local protocols. Classification definitions and terminology follow the original publication language.