Histopathology of Surgically Resected Fallopian Tubes with Special Emphasis on Serous Tubal Intraepithelial Carcinoma
Keywords:
Fallopian Tube, Serous tubal intraepithelial carcinoma, Serous adenocarcinoma, Serous tubal intraepithelial lesion
Abstract
Background: The fallopian tube, though very common surgical specimen is rarely studied. It is affected by a spectrum of lesions ranging from inflammatory to rare neoplasms. Recent studies suggest a precursor lesion for high grade serous carcinoma of the ovary in the fallopian tube mucosa and is known as serous tubal intraepithelial carcinoma. In the present study, we analyzed the histopathology of fallopian tube lesions including serous tubal intraepithelial carcinoma. Methods: All the fallopian tube specimens received were grossed according to protocol and were routinely processed and stained. Atypical proliferative lesions of mucosa were subjected to immunohistochemical markers p53 and ki67. Result: Out of 350, 106 specimens showed a spectrum of lesions, of which hydrosalpinx was the commonest. Rest of the lesions were chronic and acute salpingitis, tuberculous salpingitis and tubal endometriosis. We encountered a single case of primary serous carcinoma of the fallopian tube. Immunohistochemistry on ten cases of atypical mucosal proliferations confirmed a single case each of serous tubal intraepithelial carcinoma and serous tubal intraepithelial lesion. Conclusion: Though fallopian tube is unremarkable in most cases, thorough sampling can detect significant pathological lesions including precursor lesions.References
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2. Bagwan IN, Harke MR, Malpani MR, Deshmukh SD. Histopathological study of spectrum of lesions encountered in the fallopian tube. J Obstet Gynecol Ind 2004; 54: 379-82.
3. Patel J, Iyer RR. Spectrum of histopathological changes in fallopian tubes–a study of 350 cases. International Journal of Scientific Research. 2016 18;5(1).
4. Kurman RJ, Shih IM. The Origin and pathogenesis of epithelial ovarian cancer-a proposed unifying theory. Am J Surg Pathol. 2010;34(3):433-43.
5. Hu CY, Taymor ML, Hertig AT. Primary carcinoma of the fallopian tube. Am J Obstet Gynecol.1950 Jan 1;59(1):58-67.
6. Carlson JW, Miron A, Jarboe EA, et al. Serous tubal intraepithelial carcinoma: its potential role in primary peritoneal serous carcinoma and serous cancer prevention. J Clin Oncol. 2008 Sep 1;26(25):4160-65.
7. Semmel DR, Folkins AK, Hirsch MS, Nucci MR, Crum CP. Intercepting early pelvic serous carcinoma by routine pathological examination of the fimbria. Mod Pathol. 2009 Aug 1;22(8):985-88.
8. Vang R, Visvanathan K, Gross A, Maambo E et al. Validation of an algorithm for the diagnosis of serous tubal intraepithelial carcinoma. Int J Gynecol Pathol. 2012 May;31(3):243.
9. Grace GA, Devaleenal DB, Natrajan M. Genital tuberculosis in females. Indian J Med Res. 2017 Apr;145(4):425.
10. Jang MI, Sung JY, Kim JY, Kim HS. Clinicopathological characteristics of metaplastic papillary tumor of the fallopian tube. Anticancer Res. 2017 Jul 1;37(7):3693-701.
11. Lakshmi K, Baleswari G, Mallikarjun C, Arasi T, Rao L. Histopathological study of spectrum of lesions in the fallopian tubes. Journal of evolution of medical and dental sciences.2015 Jun;1(4):350-5.
12. Gon S, Basu A, Majumdar B, Das TK, Sengupta M, Ghosh D. Spectrum of histopathological lesions in the fallopian tubes. Journal of pathology of Nepal. 2013 Jan 1;3(5):356-60.
13. Kurman RJ, Carcangiu ML, Herrington CS, Young RH. WHO classification of tumors of Female reproductive organs 4th Edition, Lyon, World Health organization; 2014
14. Nag D, Bhaumik P, Nandi A, Samaddar A. Bilateral primary fallopian tube papillary serous carcinoma in postmenopausal woman: report of two cases. J midlife health. 2016 Jan;7(1):34.
15. Colgan TJ, Murphy J, Cole DE, Narod S, Rosen B. Occult carcinoma in prophylactic oophorectomy specimens: prevalence and association with BRCA germline mutation status. Am J Surg Pathol. 2001 Oct 1;25(10):1283-9.
16. Rabban JT, Garg K, Crawford B, Chen LM, Zaloudek CJ. Early detection of high-grade tubal serous carcinoma in women at low risk for hereditary breast and ovarian cancer syndrome by systematic examination of fallopian tubes incidentally removed during benign surgery. The Am J Surg Pathol. 2014 Jun 1;38(6):729-42.
17. Lee Y, Medeiros F, Kindelberger D, Callahan MJ, Muto MG, Crum CP. Advances in the recognition of tubal intraepithelial carcinoma: applications to cancer screening and the pathogenesis of ovarian cancer. Adv Anat Pathol. 2006 Jan 1;13(1):1-7.
18. Gwin K, Wilcox R, Montag A. Insights into selected genetic diseases affecting the female reproductive tract and their implication for pathologic evaluation of gynecologic specimens. Arch Pathol Lab Med. 2009 Jul;133(7):1041-52.
19. Mingels MJ, Van Ham MA, De Kievit IM, Snijders MP, Van Tilborg AA, Bulten J, Massuger LF. Müllerian precursor lesions in serous ovarian cancer patients: using the SEE-Fim and SEE-End protocol. Mod Pathol. 2014 Jul;27(7):1002.
20. Mahe E, Tang S, Deb P, Sur M, Lytwyn A, Daya D. Do deeper sections increase the frequency of detection of serous tubal intraepithelial carcinoma (STIC) in the “sectioning and extensively examining the FIMbriated end”(SEE-FIM) protocol?. Int J Gynecol Pathol. 2013 Jul 1;32(4):353-7.
21. Przybycin CG, Kurman RJ, Ronnett BM, Shih IM, Vang R. Are all pelvic (nonuterine) serous carcinomas of tubal origin?. Am J Surg Pathol. 2010 Oct 1;34(10):1407-16.
22. Li J, Fadare O, Xiang L, Kong B, Zheng W. Ovarian serous carcinoma: recent concepts on its origin and carcinogenesis. J Hematol Oncol. 2012 Dec;5(1):8.
23. Ferguson DC, Han LM, Wang Y et al. The role of the fallopian tube in ovarian serous carcinogenesis: biologic mechanisms and clinical impacts. Am J Clin Exp Obstet Gynecol. 2015;2(1):1-3.
Published
2019-02-26
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