Ampullary Cancer

Diagnosis

Your doctor will talk to you in detail about your symptoms and when they first appeared. He or she will then examine you and may also order blood and urine tests and ask for a stool sample.

Diagnostic tests

Mayo Clinic doctors use the latest diagnostic tests to help determine the best treatment plan for you. In tests that involve radiation, specialists carefully monitor doses to avoid the risk of radiation overexposure. Your doctor will determine which of the tests below may benefit you.

• X-rays. These generate a 2-D view of the chest and abdomen.
• Barium X-rays. For this test, you drink a liquid containing barium. The barium solution coats your intestines, allowing suspicious areas to show up better on X-rays.
• Ultrasound. Ultrasound uses high-frequency sound waves to form images on a screen to identify tumors.
• Endoscopic ultrasound (EUS). For more detailed images, an ultrasound probe is passed through a thin, lighted, flexible tube (endoscope) into your gastrointestinal tract. Doctors may use endoscopic ultrasound before surgery to determine the depth of the tumor and whether it has spread to the liver.
• Computed tomography (CT) scans. CT scans generate 2- or 3-D images that may reveal whether cancer has invaded other tissues or organs.
• Magnetic resonance imaging (MRI). An MRI uses magnetic fields and radio waves to create detailed images of the abdomen and identify small abnormalities seen in 2- and 3-D views.
• Positron emission tomography (PET). To perform a PET scan, a radioactive type of sugar (glucose) is injected into your bloodstream. The scan helps show if a tumor has spread, because tumors typically pick up the sugar and appear on the image as "hot spots."
• Endoscopy. During endoscopy, doctors use an endoscope to see the inside of the first part of the small intestine (duodenum).
• Endoscopic retrograde cholangiopancreatography (ERCP). This test uses an endoscope through which dye is injected into the pancreas and X-rays of the ducts are taken. Samples of cells from the ducts can be obtained and studied under the microscope.
• Percutaneous transhepatic cholangiography (PTC). This test can identify obstructions that may be tumors. A specialist inserts dye into the bile ducts with a thin needle and then views its movement using a specialized X-ray machine.
• Biopsy. In a biopsy, a pathologist removes a small tissue sample and looks under a microscope for cancer cells.
• Cytology. Cells can be obtained from the bile ducts from a brushing through ERCP and examined under the microscope. Specialized testing called fluorescence in situ hybridization (FISH) can be done on these cells to determine if they are cancerous (malignant).

Read more about ultrasound, CT scan, MRI, PET scan, endoscopy and biopsy.