Latest revision as of 05:11, 4 November 2024

Cross section of a Fallopian tube with decidualization. H&E stain. (WC/euthman)

Uterine tubes, also known as the Fallopian tubes, serve as a connection between the ovaries and the uterus. It is where fertilization usually takes place.

This was ignored in the past... current thinking is that it may be the real culprit in what is often labeled as "ovarian cancer".^[1]

Normal uterine tube

Architecture:

Finger-like projections into the lumen.

Cells:

Ciliated cell.
- Columnar.
- Eosinophilic cytoplasm.
Non-ciliated cell (AKA Peg cell).
- Nucleus more luminal.
  - Nuclei stick-out like a golf tee.
Secretory cells. (???)
- Basal cells, fried egg-like.

Images

www:

Overview

Benign lesions

Benign neoplasm

Adenomatoid tumour.

Pre-malignant

Serous tubal intraepithelial carcinoma (STIC).

Malignant diagnoses

Serous carcinoma.
Endometrioid adenocarcinoma.^[3]

Ditzels

Main article: Ditzels

Paratubal cyst

Also known as Hydatid cyst of Morgagni and Hydatid of Morgagni.

General

Very common.
May lead to ovarian torsion if very large.^[4]
Associated with obesity.^[5]

Gross

Thin walled-cyst with serous fluid.

Microscopic

Features:

Simple cyst with ciliated (tubal) epithelium.

Sign out

PARATUBAL CYST, RIGHT, EXCISION:
- BENIGN SIMPLE CYST.

No epithelium

PARATUBAL CYST, LEFT, EXCISION:
- BENIGN FIBROUS TISSUE COMPATIBLE WITH CYST WALL.

Tubal ligation

Abbreviated TL.

General

Done to control fertility.

Microscopic

See normal uterine tube.

DDx:

Salpingitis - inflammatory cells.
Serous carcinoma - nuclear atypia (marked), nuclear pleomorphism, prominent nucleoli.
Tubal intraepithelial carcinoma - discrete papillary growth, loss of nuclear polarity, nuclear atypia.
Endometriosis.

Sign out

Left then right

A. Fallopian Tube, Left, Tubal Ligation:
- Fallopian tube within normal limits, consistent with complete cross sections.

B. Fallopian Tube, Right, Tubal Ligation:
- Fallopian tube within normal limits, consistent with complete cross sections.

A. FALLOPIAN TUBE, LEFT, TUBAL LIGATION:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS, CONSISTENT WITH COMPLETE CROSS SECTIONS.

B. FALLOPIAN TUBE, RIGHT, TUBAL LIGATION:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS, CONSISTENT WITH COMPLETE CROSS SECTIONS.

A. FALLOPIAN TUBE, LEFT, TUBAL LIGATION:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.

B. FALLOPIAN TUBE, RIGHT, TUBAL LIGATION:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.

Right then left

A. Fallopian Tube, Right, Tubal Ligation:
- Fallopian tube within normal limits, consistent with complete cross sections.

B. Fallopian Tube, Left, Tubal Ligation:
- Fallopian tube within normal limits, consistent with complete cross sections.

A. FALLOPIAN TUBE, RIGHT, TUBAL LIGATION:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS, CONSISTENT WITH COMPLETE CROSS SECTIONS.

B. FALLOPIAN TUBE, LEFT, TUBAL LIGATION:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS, CONSISTENT WITH COMPLETE CROSS SECTIONS.

A. FALLOPIAN TUBE, RIGHT, TUBAL LIGATION:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.

B. FALLOPIAN TUBE, LEFT, TUBAL LIGATION:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.

Both in one container

Submitted as "Fallopian Tubes Right and Left", Tubal Ligation:
     - Pieces of Fallopian tube within normal limits, consistent with 
       complete cross sections.

Submitted as "Fallopian Tubes Right and Left", Partial Excision: 
     - Pieces of Fallopian tube within normal limits, consistent with 
       complete cross sections and fibril ends.

Incomplete cross sections at microscopy

Submitted as "Right and Left Fallopian Tubes", Tubal Ligation: 
     - Fallopian tubes within normal limits, incomplete cross sections 
       seen at microscopy; clinical correlation is suggested.

Mild inflammation

Submitted as "Fallopian Tubes Right and Left", Tubal Ligation: 
     - Pieces of Fallopian tube with mild inflammation otherwise within 
       normal limits, consistent with complete cross sections.

Surgical resection of previous tubal ligation

LEFT FALLOPIAN TUBE AND OVARY, LEFT SALPINGO-OOPHORECTOMY:
- FALLOPIAN TUBE WITH PARATUBAL CYSTS AND FOCAL FIBROSIS.
- OVARY WITHIN NORMAL LIMITS.

Tubes with fimbria

Submitted as "Right and Left Fallopian Tube Segments", Excision:
     - Fallopian tubes with fimbria within normal limits; complete cross sections seen.

Specific diagnoses

Salpingitis

Also suppurative salpingitis.

Also granulomatous salpingitis.

General

Benign.
May be part of pelvic inflammatory disease.

Microscopic

Features:

Inflammatory cells:
- Neutrophils = acute.
- Lymphocytes and plasma cells = chronic.
+/-Granulomas; known as granulomatous salpingitis.
+/-Clusters of neutrophils = abscess; known as suppurative salpingitis.

Images

Salpingitis - low mag. (WC)
Salpingitis - high mag. (WC)
Granulomatous salpingitis - intermed mag. (WC)
Granulomatous salpingitis - high mag. (WC)

Stains

If organisms are seen on routine stains:

Gram stain +ve/-ve.

Granulomatous inflammation:

Ziehl-Neelsen stain +ve/-ve.
GMS stain +ve/-ve.
PASD stain +ve/-ve.

Ectopic pregnancy

Main article: Ectopic pregnancy

Adenofibroma

General

Rare.^[6]
- More frequently seen than in the past -- presumably as pathologists are looking more closely at the Fallopian tube.
Cannot be disguished from ovarian adenofibroma.^[6]

Gross

Solid, nodular.

Microscopic

Features:^[6]

Stroma + glandular elements.
- Glandular elements: secretory cells and ciliated cells.

IHC

Features:

Stroma:^[6]
- CD10 +ve.
- Inhibin +ve.

Salpingitis isthmica nodosa

Abbreviated SIN.
AKA adenosalpingitis,^[7] and diverticulosis of the Fallopian tubes.^[8]

General

Associated with infertility and ectopic pregnancy.^[9]
SIN is uncommonly bilateral.^[10]

Diagnosis (clinical):

Hysterosalpingography.^[11]
- Finding: diverticula.

Notes:

The male cousin of this is: vasitis nodosa.

Microscopic

Features:^[12]

Nodular thickening of the tunica muscularis of the isthmic portion.
Cystically dilated glands.
+/-Complete obliteration of tubal lumen.

Images:

WC:
- SIN - very low mag. (WC).
www:
- SIN (pathologypics.com).

Adenomatoid tumour

See: Adenomatoid tumours (uterine tumours).

General

Relatively common tumour of the fallopian tube.^[13]

Microscopic

See: Adenomatoid tumours (uterine tumours).

Serous tubal intraepithelial carcinoma

Abbreviated STIC.^[14]
AKA tubal intraepithelial carcinoma.

Main article: Serous tubal intraepithelial carcinoma

Serous carcinoma of the fallopian tube

Main article: Serous carcinoma of the fallopian tube

References

↑ Hirst, JE.; Gard, GB.; McIllroy, K.; Nevell, D.; Field, M. (Jul 2009). "High rates of occult fallopian tube cancer diagnosed at prophylactic bilateral salpingo-oophorectomy.". Int J Gynecol Cancer 19 (5): 826-9. doi:10.1111/IGC.0b013e3181a1b5dc. PMID 19574767.
↑ URL: http://faculty.une.edu/com/abell/histo/histolab3f.htm. Accessed on: 18 October 2011.
↑ Navani, SS.; Alvarado-Cabrero, I.; Young, RH.; Scully, RE. (Dec 1996). "Endometrioid carcinoma of the fallopian tube: a clinicopathologic analysis of 26 cases.". Gynecol Oncol 63 (3): 371-8. doi:10.1006/gyno.1996.0338. PMID 8946874.
↑ Thakore, SS.; Chun, MJ.; Fitzpatrick, K. (Aug 2012). "Recurrent ovarian torsion due to paratubal cysts in an adolescent female.". J Pediatr Adolesc Gynecol 25 (4): e85-7. doi:10.1016/j.jpag.2011.10.012. PMID 22840942.
↑ Muolokwu, E.; Sanchez, J.; Bercaw, JL.; Sangi-Haghpeykar, H.; Banszek, T.; Brandt, ML.; Dietrich, JE. (Nov 2011). "Paratubal cysts, obesity, and hyperandrogenism.". J Pediatr Surg 46 (11): 2164-7. doi:10.1016/j.jpedsurg.2011.07.011. PMID 22075351.
↑ ^6.0 ^6.1 ^6.2 ^6.3 Bossuyt, V.; Medeiros, F.; Drapkin, R.; Folkins, AK.; Crum, CP.; Nucci, MR. (Jul 2008). "Adenofibroma of the fimbria: a common entity that is indistinguishable from ovarian adenofibroma.". Int J Gynecol Pathol 27 (3): 390-7. doi:10.1097/PGP.0b013e3181639a82. PMID 18580316.
↑ Stedman's Medical Dictionary. 27th Ed. Lippincott Williams & Wilkins.
↑ URL: http://www.medcyclopaedia.com/library/topics/volume_iv_2/s/salpingitis_isthmica_nodosa.aspx. Accessed on: 28 July 2010.
↑ Jenkins, CS.; Williams, SR.; Schmidt, GE. (Oct 1993). "Salpingitis isthmica nodosa: a review of the literature, discussion of clinical significance, and consideration of patient management.". Fertil Steril 60 (4): 599-607. PMID 8405510.
↑ Skibsted, L.; Sperling, L.; Hansen, U.; Hertz, J. (Jul 1991). "Salpingitis isthmica nodosa in female infertility and tubal diseases.". Hum Reprod 6 (6): 828-31. PMID 1757522.
↑ URL: http://radiology.rsna.org/content/154/3/597.abstract. Accessed on: 28 July 2010.
↑ Chawla, N.; Kudesia, S.; Azad, S.; Singhal, M.; Rai, SM.. "Salpingitis isthmica nodosa.". Indian J Pathol Microbiol 52 (3): 434-5. doi:10.4103/0377-4929.55019. PMID 19679986.
↑ Christensen C (1990). "Adenomatoid tumors of the uterus". Eur. J. Gynaecol. Oncol. 11 (2): 85–9. PMID 2199199.
↑ Visvanathan, K.; Vang, R.; Shaw, P.; Gross, A.; Soslow, R.; Parkash, V.; Shih, IeM.; Kurman, RJ. (Dec 2011). "Diagnosis of serous tubal intraepithelial carcinoma based on morphologic and immunohistochemical features: a reproducibility study.". Am J Surg Pathol 35 (12): 1766-75. doi:10.1097/PAS.0b013e31822f58bc. PMID 21989347.

[pmid19574767-1] Hirst, JE.; Gard, GB.; McIllroy, K.; Nevell, D.; Field, M. (Jul 2009). "High rates of occult fallopian tube cancer diagnosed at prophylactic bilateral salpingo-oophorectomy.". Int J Gynecol Cancer 19 (5): 826-9. doi:10.1111/IGC.0b013e3181a1b5dc. PMID 19574767.

[2] URL: http://faculty.une.edu/com/abell/histo/histolab3f.htm. Accessed on: 18 October 2011.

[pmid8946874-3] Navani, SS.; Alvarado-Cabrero, I.; Young, RH.; Scully, RE. (Dec 1996). "Endometrioid carcinoma of the fallopian tube: a clinicopathologic analysis of 26 cases.". Gynecol Oncol 63 (3): 371-8. doi:10.1006/gyno.1996.0338. PMID 8946874.

[pmid22840942-4] Thakore, SS.; Chun, MJ.; Fitzpatrick, K. (Aug 2012). "Recurrent ovarian torsion due to paratubal cysts in an adolescent female.". J Pediatr Adolesc Gynecol 25 (4): e85-7. doi:10.1016/j.jpag.2011.10.012. PMID 22840942.

[5] Muolokwu, E.; Sanchez, J.; Bercaw, JL.; Sangi-Haghpeykar, H.; Banszek, T.; Brandt, ML.; Dietrich, JE. (Nov 2011). "Paratubal cysts, obesity, and hyperandrogenism.". J Pediatr Surg 46 (11): 2164-7. doi:10.1016/j.jpedsurg.2011.07.011. PMID 22075351.

[pmid18580316-6] 6.0 ^6.1 ^6.2 ^6.3 Bossuyt, V.; Medeiros, F.; Drapkin, R.; Folkins, AK.; Crum, CP.; Nucci, MR. (Jul 2008). "Adenofibroma of the fimbria: a common entity that is indistinguishable from ovarian adenofibroma.". Int J Gynecol Pathol 27 (3): 390-7. doi:10.1097/PGP.0b013e3181639a82. PMID 18580316.

[7] Stedman's Medical Dictionary. 27th Ed. Lippincott Williams & Wilkins.

[8] URL: http://www.medcyclopaedia.com/library/topics/volume_iv_2/s/salpingitis_isthmica_nodosa.aspx. Accessed on: 28 July 2010.

[pmid8405510-9] Jenkins, CS.; Williams, SR.; Schmidt, GE. (Oct 1993). "Salpingitis isthmica nodosa: a review of the literature, discussion of clinical significance, and consideration of patient management.". Fertil Steril 60 (4): 599-607. PMID 8405510.

[pmid1757522-10] Skibsted, L.; Sperling, L.; Hansen, U.; Hertz, J. (Jul 1991). "Salpingitis isthmica nodosa in female infertility and tubal diseases.". Hum Reprod 6 (6): 828-31. PMID 1757522.

[11] URL: http://radiology.rsna.org/content/154/3/597.abstract. Accessed on: 28 July 2010.

[pmid19679986-12] Chawla, N.; Kudesia, S.; Azad, S.; Singhal, M.; Rai, SM.. "Salpingitis isthmica nodosa.". Indian J Pathol Microbiol 52 (3): 434-5. doi:10.4103/0377-4929.55019. PMID 19679986.

[pmid2199199-13] Christensen C (1990). "Adenomatoid tumors of the uterus". Eur. J. Gynaecol. Oncol. 11 (2): 85–9. PMID 2199199.

[pmid21989347-14] Visvanathan, K.; Vang, R.; Shaw, P.; Gross, A.; Soslow, R.; Parkash, V.; Shih, IeM.; Kurman, RJ. (Dec 2011). "Diagnosis of serous tubal intraepithelial carcinoma based on morphologic and immunohistochemical features: a reproducibility study.". Am J Surg Pathol 35 (12): 1766-75. doi:10.1097/PAS.0b013e31822f58bc. PMID 21989347.

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[14]

@@ Line 1: / Line 1: @@
+[[Image:Normal Fallopian Tube, Human (2760475010).jpg|thumb|Cross section of a Fallopian tube with decidualization. [[H&E stain]]. (WC/euthman)]]
 '''Uterine tubes''', also known as the '''Fallopian tubes''', serve as a connection between the [[ovary|ovaries]] and the [[uterus]].  It is where fertilization usually takes place.
@@ Line 14: / Line 15: @@
 #*Nucleus more luminal.
 #**Nuclei stick-out like a golf tee.
-#Secretory cells.
+#Secretory cells. (???)
 #*Basal cells, fried egg-like.
-Images:
+See also:
+*[[Walthard cell rest]].
+===Images===
+www:
 *[http://faculty.une.edu/com/abell/histo/ampovidw.jpg Fallopian tube (une.edu)].<ref>URL: [http://faculty.une.edu/com/abell/histo/histolab3f.htm http://faculty.une.edu/com/abell/histo/histolab3f.htm]. Accessed on: 18 October 2011.</ref>
 *[http://medpics.ucsd.edu/index.cfm?curpage=image&course=hist&mode=browse&lesson=37&img=669 Fallopian tube (medpics.ucsd.edu)].
@@ Line 42: / Line 47: @@
 {{Main|Ditzels}}
 ==Paratubal cyst==
+*Also known as ''Hydatid cyst of Morgagni'' and ''Hydatid of Morgagni''.
 ===General===
 *Very common.
 *May lead to ovarian torsion if very large.<ref name=pmid22840942>{{Cite journal  | last1 = Thakore | first1 = SS. | last2 = Chun | first2 = MJ. | last3 = Fitzpatrick | first3 = K. | title = Recurrent ovarian torsion due to paratubal cysts in an adolescent female. | journal = J Pediatr Adolesc Gynecol | volume = 25 | issue = 4 | pages = e85-7 | month = Aug | year = 2012 | doi = 10.1016/j.jpag.2011.10.012 | PMID = 22840942 }}
 </ref>
+*Associated with [[obesity]].<ref>{{Cite journal  | last1 = Muolokwu | first1 = E. | last2 = Sanchez | first2 = J. | last3 = Bercaw | first3 = JL. | last4 = Sangi-Haghpeykar | first4 = H. | last5 = Banszek | first5 = T. | last6 = Brandt | first6 = ML. | last7 = Dietrich | first7 = JE. | title = Paratubal cysts, obesity, and hyperandrogenism. | journal = J Pediatr Surg | volume = 46 | issue = 11 | pages = 2164-7 | month = Nov | year = 2011 | doi = 10.1016/j.jpedsurg.2011.07.011 | PMID = 22075351 }}</ref>
 ===Gross===
@@ Line 82: / Line 89: @@
 ===Sign out===
 ====Left then right====
+<pre>
+A. Fallopian Tube, Left, Tubal Ligation:
+- Fallopian tube within normal limits, consistent with complete cross sections.
+B. Fallopian Tube, Right, Tubal Ligation:
+- Fallopian tube within normal limits, consistent with complete cross sections.
+</pre>
 <pre>
 A. FALLOPIAN TUBE, LEFT, TUBAL LIGATION:
@@ Line 99: / Line 114: @@
 ====Right then left====
+<pre>
+A. Fallopian Tube, Right, Tubal Ligation:
+- Fallopian tube within normal limits, consistent with complete cross sections.
+B. Fallopian Tube, Left, Tubal Ligation:
+- Fallopian tube within normal limits, consistent with complete cross sections.
+</pre>
 <pre>
 A. FALLOPIAN TUBE, RIGHT, TUBAL LIGATION:
@@ Line 113: / Line 136: @@
 B. FALLOPIAN TUBE, LEFT, TUBAL LIGATION:
 - FALLOPIAN TUBE WITHIN NORMAL LIMITS.
+</pre>
+====Both in one container====
+<pre>
+Submitted as "Fallopian Tubes Right and Left", Tubal Ligation:
+     - Pieces of Fallopian tube within normal limits, consistent with
+       complete cross sections.
+</pre>
+<pre>
+Submitted as "Fallopian Tubes Right and Left", Partial Excision:
+     - Pieces of Fallopian tube within normal limits, consistent with
+       complete cross sections and fibril ends.
+</pre>
+=====Incomplete cross sections at microscopy=====
+<pre>
+Submitted as "Right and Left Fallopian Tubes", Tubal Ligation:
+     - Fallopian tubes within normal limits, incomplete cross sections
+       seen at microscopy; clinical correlation is suggested.
+</pre>
+=====Mild inflammation=====
+<pre>
+Submitted as "Fallopian Tubes Right and Left", Tubal Ligation:
+     - Pieces of Fallopian tube with mild inflammation otherwise within
+       normal limits, consistent with complete cross sections.
 </pre>
@@ Line 120: / Line 170: @@
 - FALLOPIAN TUBE WITH PARATUBAL CYSTS AND FOCAL FIBROSIS.
 - OVARY WITHIN NORMAL LIMITS.
+</pre>
+====Tubes with fimbria====
+<pre>
+Submitted as "Right and Left Fallopian Tube Segments", Excision:
+     - Fallopian tubes with fimbria within normal limits; complete cross sections seen.
 </pre>
@@ Line 138: / Line 194: @@
 *+/-Clusters of neutrophils = abscess; known as ''suppurative salpingitis''.
-Images:
+====Images====
-*[http://commons.wikimedia.org/wiki/File:Salpingitis_-_low_mag.jpg Salpingitis - low mag. (WC)].
+<gallery>
-*[http://commons.wikimedia.org/wiki/File:Salpingitis_-_high_mag.jpg Salpingitis - high mag. (WC)].
+File:Salpingitis_-_low_mag.jpg | Salpingitis - low mag. (WC)
-*[http://commons.wikimedia.org/wiki/File:Granulomatous_salpingitis_-_intermed_mag.jpg Granulomatous salpingitis - intermed mag. (WC)].
+File:Salpingitis_-_high_mag.jpg | Salpingitis - high mag. (WC)
-*[http://commons.wikimedia.org/wiki/File:Granulomatous_salpingitis_-_high_mag.jpg Granulomatous salpingitis - high mag. (WC)].
+File:Granulomatous_salpingitis_-_intermed_mag.jpg | Granulomatous salpingitis - intermed mag. (WC)
+File:Granulomatous_salpingitis_-_high_mag.jpg | Granulomatous salpingitis - high mag. (WC)
+</gallery>
 ===Stains===
 If organisms are seen on routine stains:
@@ Line 152: / Line 209: @@
 *[[GMS stain]] +ve/-ve.
 *[[PASD stain]] +ve/-ve.
+==Ectopic pregnancy==
+{{Main|Ectopic pregnancy}}
 ==Adenofibroma==
@@ Line 211: / Line 271: @@
 *[[AKA]] ''tubal intraepithelial carcinoma''.
 {{Main|Serous tubal intraepithelial carcinoma}}
+==Serous carcinoma of the fallopian tube==
+{{Main|Serous carcinoma of the fallopian tube}}
 =See also=

Difference between revisions of "Uterine tubes"

Latest revision as of 05:11, 4 November 2024

Normal uterine tube

Images

Overview

Benign lesions

Benign neoplasm

Pre-malignant

Malignant diagnoses

Ditzels

Paratubal cyst

General

Gross

Microscopic

Sign out

No epithelium

Tubal ligation

General

Microscopic

Sign out

Left then right

Right then left

Both in one container

Incomplete cross sections at microscopy

Mild inflammation

Surgical resection of previous tubal ligation

Tubes with fimbria

Specific diagnoses

Salpingitis

General

Microscopic

Images

Stains

Ectopic pregnancy

Adenofibroma

General

Gross

Microscopic

IHC

Salpingitis isthmica nodosa

General

Microscopic

Adenomatoid tumour

General

Microscopic

Serous tubal intraepithelial carcinoma

Serous carcinoma of the fallopian tube

See also

References

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