| Large ampullary carcinoma | 
              Feb 26, 2009 | 
             
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        | A 64-years-old woman presented with intermittent jaundice and anemia. EUS showed a large mass  projected in the papillary area, invading the pancreatic parenchyma. EUS elastography showed the mass as hard (blue). The diagnosis was confirmed by EUS-guided FNA, which showed an adenocarcinoma.  | 
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              | Ampullary carcinoma | 
              Feb 5, 2005 | 
             
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        | Ulcerated tumor visualized as a hypoechoic mass at the level of major papilla (arrows), with integrity of the muscle layer (arrow heads) (T2). The tumor was identified with a lateral  viewing duodenoscope as an ulcerated mass at the level of the ampula Vater; biopsies confirmed the diagnosis of moderately differentiated adenocarcinoma. | 
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              | Intramural ampullary carcinoma | 
              Feb 5, 2005 | 
             
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        | Linear EUS identified a hypoechoic tumor (16 mm) at the level of major papilla (arrows), with invasion of the pancreatic parenchyma (T3). The major papilla was subsequently visualized with a lateral viewing duodenoscope, having a normal covering mucosa. However, biopsies taken after biliary sphincterotomy confirmed the diagnosis of adenocarcinoma. | 
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