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CLASSIFICATION
Classification
Uchiyama ME-NBI classification (ampulla)
ME-NBI classification of ampullary tumors by surface structure (Type I / II / III) and abnormal vessels. Type I suggests inflammation or hyperplasia; Type II/III suggests adenoma or carcinoma; abnormal vessels suggest adenocarcinoma.
Classification overview
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Surface
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Type I · Oval-shaped villi
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Type II · Pinecone / leaf-shaped villi
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Type III · Irregular / nonstructured
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Vessels
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Abnormal vessels · Dilated, tortuous, or network-like
Surface
Type I
Oval-shaped villi
Surface
Oval-shaped villi on ME-NBI
Pathology
Inflammation or hyperplastic lesion
Type II
Pinecone / leaf-shaped villi
Surface
Pinecone-shaped or leaf-shaped villi
Pathology
Adenoma or adenocarcinoma
Note: Neoplastic — confirm with biopsy.
Type III
Irregular / nonstructured
Surface
Irregular or nonstructured surface pattern
Pathology
Adenoma or adenocarcinoma
Vessels
Abnormal vessels
Dilated, tortuous, or network-like
Definition
Dilated, tortuous, or network-like vessels; or vessel disappearance on the papillary lesion
Pathology
Adenocarcinoma (not seen in adenoma alone in the original series)
Note: Useful to differentiate adenoma from adenocarcinoma; evaluate with surface type.
Uchiyama 2006, Original
More reference figures
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Reference
Original article
Uchiyama Y et al. J Gastroenterol 2006;41:483-490
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SCORE
Spigelman
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