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Ampulla of Vater
Anatomy of the ampulla of Vater, strategically located at the confluence of the pancreatic and
common bile ducts.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
Regional lymph nodes of the ampulla of Vater include lymph nodes in the region of the head
of the pancreas, and those of the hepatic artery and pyloric regions. Lymph nodes along
the distal body and tail of the pancreas are not considered regional lymph nodes for the
ampulla of Vater.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
Regional lymph nodes of the ampulla of Vater, namely the proximal mesenteric and common
bile duct lymph nodes. The celiac axis lymph nodes, the splenic lymph nodes and lymph
nodes along the distal body and tail of the pancreas are not considered regional lymph
nodes for the ampulla of Vater.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
Two views of T1: tumor limited to ampulla of Vater (below dotted line) or sphincter of Oddi
(tumor shown above dotted line).
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
T2 is defined as tumor invading duodenal wall.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
T3 is defined as tumor invading pancreas.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
T4 is defined as tumor invading peripancreatic soft tissues or other adjacent
organs or structures.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
N1 is defined as regional lymph node metastasis.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
N1 is defined as regional lymph node metastasis. This image highlights some nodes that
are not considered regional.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
N1 is defined as regional lymph node metastasis.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
M1 is defined as distant metastasis, here to lymph nodes of the tail of the pancreas.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
Ampulla of Vater
M1 is defined as distant metastasis, here to the splenic lymph nodes and lymph nodes of
the tail of the pancreas.
Compton, C.C., Byrd, D.R., et al., Editors. AJCC CancerStaging Atlas, 2nd Edition. New York: Springer, 2012. ©American Joint Committee on Cancer
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