Difference between revisions of "Uterine tubes"

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'''Uterine tubes''', aka '''Fallopian tubes''', serve as a connection the [[ovary]] and [[uterus]].  It is where fertilization usually takes place.
[[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.


This was ignored in the past... current thinking is that it may be the real culprit in what is often labeled as "ovarian cancer".<ref name=pmid19574767>{{Cite journal  | last1 = Hirst | first1 = JE. | last2 = Gard | first2 = GB. | last3 = McIllroy | first3 = K. | last4 = Nevell | first4 = D. | last5 = Field | first5 = M. | title = High rates of occult fallopian tube cancer diagnosed at prophylactic bilateral salpingo-oophorectomy. | journal = Int J Gynecol Cancer | volume = 19 | issue = 5 | pages = 826-9 | month = Jul | year = 2009 | doi = 10.1111/IGC.0b013e3181a1b5dc | PMID = 19574767 }}</ref>
This was ignored in the past... current thinking is that it may be the real culprit in what is often labeled as "[[ovarian cancer]]".<ref name=pmid19574767>{{Cite journal  | last1 = Hirst | first1 = JE. | last2 = Gard | first2 = GB. | last3 = McIllroy | first3 = K. | last4 = Nevell | first4 = D. | last5 = Field | first5 = M. | title = High rates of occult fallopian tube cancer diagnosed at prophylactic bilateral salpingo-oophorectomy. | journal = Int J Gynecol Cancer | volume = 19 | issue = 5 | pages = 826-9 | month = Jul | year = 2009 | doi = 10.1111/IGC.0b013e3181a1b5dc | PMID = 19574767 }}</ref>


==Normal==
=Normal uterine tube=
Architecture:
Architecture:
*Finger-like projections into the lumen.
*Finger-like projections into the lumen.


Cells:
Cells:
#Ciliated cells.
#Ciliated cell.
#*Columnar.
#*Columnar.
#*Eosinophilic cytoplasm.
#*Eosinophilic cytoplasm.
#Peg cells.
#Non-ciliated cell ([[AKA]] Peg cell).
#*Nucleus more luminal.
#*Nucleus more luminal.
#**Nuclei stick-out like a golf tee.
#**Nuclei stick-out like a golf tee.
#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://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)].
*[http://medpics.ucsd.edu/index.cfm?curpage=image&course=hist&mode=browse&lesson=37&img=669 Fallopian tube (medpics.ucsd.edu)].
*[http://www.ouhsc.edu/histology/Glass%20slides/18_09.jpg Uterine tube - cells (ouhsc.edu)].
*[http://www.ouhsc.edu/histology/Glass%20slides/18_10.jpg Uterine tube - wall (ouhsc.edu)].
=Overview=
===Benign lesions===
*[[Paratubal cyst]].
*[[Salpingitis isthmica nodosa]].
*[[Endometriosis]].
===Benign neoplasm===
*[[Adenomatoid tumour]].
===Pre-malignant===
*[[Serous tubal intraepithelial carcinoma]] (STIC).
===Malignant diagnoses===
*Serous carcinoma.
*Endometrioid adenocarcinoma.<ref name=pmid8946874>{{Cite journal  | last1 = Navani | first1 = SS. | last2 = Alvarado-Cabrero | first2 = I. | last3 = Young | first3 = RH. | last4 = Scully | first4 = RE. | title = Endometrioid carcinoma of the fallopian tube: a clinicopathologic analysis of 26 cases. | journal = Gynecol Oncol | volume = 63 | issue = 3 | pages = 371-8 | month = Dec | year = 1996 | doi = 10.1006/gyno.1996.0338 | PMID = 8946874 }}</ref>
=Ditzels=
{{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===
*Thin walled-cyst with serous fluid.
===Microscopic===
Features:
*Simple cyst with ciliated (tubal) epithelium.
===Sign out===
<pre>
PARATUBAL CYST, RIGHT, EXCISION:
- BENIGN SIMPLE CYST.
</pre>
====No epithelium====
<pre>
PARATUBAL CYST, LEFT, EXCISION:
- BENIGN FIBROUS TISSUE COMPATIBLE WITH CYST WALL.
</pre>
==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====
<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:
- 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:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
B. FALLOPIAN TUBE, RIGHT, TUBAL LIGATION:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
</pre>
====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:
- 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:
- FALLOPIAN TUBE WITHIN NORMAL LIMITS.
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>
=====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>
====Surgical resection of previous tubal ligation====
<pre>
LEFT FALLOPIAN TUBE AND OVARY, LEFT SALPINGO-OOPHORECTOMY:
- FALLOPIAN TUBE WITH PARATUBAL CYSTS AND FOCAL FIBROSIS.
- OVARY WITHIN NORMAL LIMITS.
</pre>


=Specific diagnoses=
==Salpingitis==
==Salpingitis==
:Also ''suppurative salpingitis''.
:Also ''suppurative salpingitis''.
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*+/-Clusters of neutrophils = abscess; known as ''suppurative salpingitis''.
*+/-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===
===Stains===
If organisms are seen on routine stains:
If organisms are seen on routine stains:
Line 48: Line 197:
*[[GMS stain]] +ve/-ve.
*[[GMS stain]] +ve/-ve.
*[[PASD stain]] +ve/-ve.
*[[PASD stain]] +ve/-ve.
==Ectopic pregnancy==
{{Main|Ectopic pregnancy}}


==Adenofibroma==
==Adenofibroma==
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See: ''[[Uterine_tumours#Adenomatoid_tumour|Adenomatoid tumours (uterine tumours)]]''.
See: ''[[Uterine_tumours#Adenomatoid_tumour|Adenomatoid tumours (uterine tumours)]]''.


==See also==
==Serous tubal intraepithelial carcinoma==
*Abbreviated ''STIC''.<ref name=pmid21989347>{{Cite journal  | last1 = Visvanathan | first1 = K. | last2 = Vang | first2 = R. | last3 = Shaw | first3 = P. | last4 = Gross | first4 = A. | last5 = Soslow | first5 = R. | last6 = Parkash | first6 = V. | last7 = Shih | first7 = IeM. | last8 = Kurman | first8 = RJ. | title = Diagnosis of serous tubal intraepithelial carcinoma based on morphologic and immunohistochemical features: a reproducibility study. | journal = Am J Surg Pathol | volume = 35 | issue = 12 | pages = 1766-75 | month = Dec | year = 2011 | doi = 10.1097/PAS.0b013e31822f58bc | PMID = 21989347 }}</ref>
*[[AKA]] ''tubal intraepithelial carcinoma''.
{{Main|Serous tubal intraepithelial carcinoma}}
 
=See also=
*[[Gynecologic pathology]].
*[[Gynecologic pathology]].
*[[Ovary]].
*[[Ovary]].


==References==
=References=
{{reflist|2}}
{{reflist|2}}


[[Category:Gynecologic pathology]]
[[Category:Gynecologic pathology]]
[[Category:Uterine tubes]]
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