Pathology of the Fallopian Tube

Abstract

The fallopian tubes are subjected to a variety of inflammatory and neoplastic lesions. Reactive changes secondary to inflammation may potentially mimic malignancy. Many reactive and benign conditions may also result in tubal narrowing or occlusion and are often the underlying causes of ectopic pregnancy. The tube is the most frequent site of an ectopic pregnancy but is rare for primary gestational trophoblastic diseases. The latter are usually secondary to a lesion from the corpus. Tubal hyperplasia is a poorly defined and overlapping entity; in many cases, they represent precursor lesions of tubal borderline or malignant lesions. Recent advances in genetic testing for BRCA mutations in high-risk families had led to the recognition of early carcinomas of the fallopian tube in prophylactic bilateral salpingo-oophorectomy specimens. Tubal intraepithelial carcinoma has become the topic of vigorous research in recent years, and this lesion, particularly when found in the fimbriae, is now recognized as the source some ovarian and peritoneal high-grade serous carcinomas. Secondary involvement of the tubes by ovarian carcinomas or those of other sites is more common than primary tubal carcinomas. The commonest primary carcinomas of the fallopian tube are of serous differentiation, followed by endometrioid and transitional cell. Mesenchymal tumors are rare. Benign and malignant tumors of the broad ligament are similar to those arising from the ovaries in many aspects. Identification of sites of origin may sometimes be difficult.