{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T09:20:59Z","timestamp":1787908859232,"version":"build-2784847793"},"reference-count":14,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Adenomyomatous hyperplasia (AH) of the Vaterian system is a rare benign lesion, often clinically mistaken for carcinoma and leading to unnecessary Whipple surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicentre cohort, Whipple pancreaticoduodenectomy specimens were identified and operated on with a clinical diagnosis of ampullary tumor, which on histological examination, however, showed AH, collected over 3 years (2022-2024). In this retrospective observational study, we analyzed the clinico-radiological and histological details of 12 of such patients and described them here.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In these 12 patients with pancreaticoduodenectomy, the mean age was 51.7 years (range 29 to 63 years) with a male-to-female patient ratio of 9:3. Although abdominal pain was the most common presentation (11\/12 patients); obstructive jaundice occurred in two. The preoperative imaging revealed common bile duct dilatation (11\/12) and double duct sign (6\/12), with the suspicion of carcinoma in all. Grossly, the lesions measured 0.4 to 4.3\u2005cm (median 1.4\u2005cm), six centered on the ampulla, others extending to the pancreatic head or the distal bile duct. Microscopy showed bland mucous glands, smooth muscle, and fibroblasts; immunohistochemistry confirmed keratin 7, MUC6, MUC5AC, and actin positivity. Ki-67 index was low. No recurrences occurred during 6-48 months follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinicoradiologically, ampullary AH mimics ampullary malignancy. However, AH should be considered in the clinicopathologic differential diagnosis of ampullary lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10668969261457932","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:48:30Z","timestamp":1785246510000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adenomyomatous Hyperplasia of the Vaterian System: The Hidden Culprit Behind Whipple Procedures"],"prefix":"10.1177","author":[{"given":"Bharathi","family":"Prabakaran","sequence":"first","affiliation":[{"name":"All India Institute of medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumble S.","family":"Madhusudhan","sequence":"additional","affiliation":[{"name":"All India Institute of medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Panwar","sequence":"additional","affiliation":[{"name":"All India Institute of medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asuri","family":"Krishna","sequence":"additional","affiliation":[{"name":"All India Institute of medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemanga K.","family":"Bhattacharjee","sequence":"additional","affiliation":[{"name":"All India Institute of medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sweta","family":"Bhartiya","sequence":"additional","affiliation":[{"name":"All India Institute of medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venu Madhav","family":"Jarapala","sequence":"additional","affiliation":[{"name":"All India Institute of medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7597-4895","authenticated-orcid":false,"given":"Rajni","family":"Yadav","sequence":"additional","affiliation":[{"name":"All India Institute of medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-5941","authenticated-orcid":false,"given":"Pooja","family":"Sakhuja","sequence":"additional","affiliation":[{"name":"Govind Ballabh Pant Institute of Postgraduate Medical Education and Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil Kumar","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Govind Ballabh Pant Institute of Postgraduate Medical Education and Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rifat","family":"Mannan","sequence":"additional","affiliation":[{"name":"Department of Pathology, City of Hope Comprehensive Cancer, Duarte, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2420-8573","authenticated-orcid":false,"given":"Prasenjit","family":"Das","sequence":"additional","affiliation":[{"name":"All India Institute of medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.MP.0000073525.71096.8F"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s005950200205"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1159\/000507788"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4166\/kjg.2016.67.6.332"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/2011.8.6"},{"issue":"1","key":"e_1_3_2_7_2","first-page":"80","article-title":"Adenomyoma of ampulla: a report of three cases of a rare entity","volume":"8","author":"Cheddadi M","year":"2024","unstructured":"Cheddadi M, El Mohtarim R, Sassi S, Derqaoui S, Znati K, Jahid A. Adenomyoma of ampulla: a report of three cases of a rare entity. J Cancer Sci Clin Therap. 2024;8(1):80-82.","journal-title":"J Cancer Sci Clin Therap"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2023.11.016"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.20258"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000034080"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1159\/000331052"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2014.05.013"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181f8ff05"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40792-024-01822-z"},{"issue":"5","key":"e_1_3_2_15_2","first-page":"400","article-title":"Role of computed quantitation of immunohistochemical staining of Ki-67 antigen in diagnosing ampullary lesions","volume":"18","author":"Minimo C","year":"1996","unstructured":"Minimo C, McCue PA, Pindzola A, Brennan J, Bibbo M. Role of computed quantitation of immunohistochemical staining of Ki-67 antigen in diagnosing ampullary lesions. Anal Quant Cytol Histol. 1996;18(5):400-404. 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