Fallopian tubes: Difference between revisions
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→Gross processing: +Paratubal cysts |
m →Neoplasias: bold |
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{{Top | <noinclude>{{Top | ||
|author1=[[User:Mikael Häggström|Mikael Häggström]] | |author1=[[User:Mikael Häggström|Mikael Häggström]] | ||
|author2= | |author2= | ||
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*For sterilization | *For sterilization | ||
*[[Fallopian tube in ectopic pregnancy]] | *[[Fallopian tube in ectopic pregnancy]] | ||
{{Comprehensiveness}}</noinclude> | |||
==Gross processing== | |||
[[File:Gross pathology of paratubal cysts.jpg|thumb|'''[[Paratubal cysts]]''' can be ignored if incidentally found.]] | |||
{{Moderate-begin}}Look in the history for any intra-fallopian coils (Essure devices).{{Moderate-end}}<ref group=note>For a case with intra-fallopian coils in the medical records, an inability to find them on gross processing must be noted in order to raise the possibility of coil expulsion.</ref> | |||
;For sterilization: | ;For sterilization: | ||
*'''Measure''' length and average diameter of each tube | *'''Measure''' length and average diameter of each tube | ||
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==Microscopic examination== | ==Microscopic examination== | ||
[[File:Histopathology of edematous fallopian tubes.jpg|thumb|220px|Fallopian tubes may be substantially edematous and congested, which can generally be attributed to surgery, in which case it does not need mention in the report.]] | |||
*Ensure there is at least one full cross-section from each tube, and take further samples otherwise. | *Ensure there is at least one full cross-section from each tube, and take further samples otherwise. | ||
*Check for patency of the lumen. | *Check for patency of the lumen. | ||
=== | ===Neoplasias=== | ||
Look for: | |||
<gallery mode=packed heights= | *'''Adenomatoid tumor''', the most common tumor of the fallopian tubes:<ref name=adenomatoid>{{cite web|url=http://www.pathologyoutlines.com/topic/fallopiantubesadenomatoid.html|title=Fallopian tubes & broad ligament - Fallopian tube tumors - Adenomatoid tumor|author=Nicole Riddle, Jamie Shutter|website=Pathology Outlines}} Topic Completed: 1 September 2013. Minor changes: 13 December 2019</ref> | ||
<gallery mode=packed heights=230> | |||
File:Histopathology of an adenomatoid tumor of the fallopian tube, low magnification.jpg|An '''adenomatoid tumor''' of the fallopian tube, low magnification, displaying infiltrative-like borders. | File:Histopathology of an adenomatoid tumor of the fallopian tube, low magnification.jpg|An '''adenomatoid tumor''' of the fallopian tube, low magnification, displaying infiltrative-like borders. | ||
File:Histopathology of an adenomatoid tumor of the fallopian tube, intermediate magnification.jpg|High magnification of the same case, showing the typical<ref name=adenomatoid/> features of tubular spaces of varying size composed of flattened cells resembling endothelium. | File:Histopathology of an adenomatoid tumor of the fallopian tube, intermediate magnification.jpg|High magnification of the same case, showing the typical<ref name=adenomatoid/> features of tubular spaces of varying size composed of flattened cells resembling endothelium. | ||
</gallery> | </gallery> | ||
*'''Atypia/crowding''' of the serous epithelium. | |||
[[File:Histopathology of serous tubal intraepithelial lesion (STIL).jpg|thumb|Serous tubal intraepithelial lesion (STIL).<ref>{{cite journal | |||
| last1 = Mizuno | |||
| first1 = M | |||
| last2 = Togami | |||
| first2 = S | |||
| last3 = Shirota | |||
| first3 = K | |||
| last4 = et al. | |||
| title = Three Cases of Serous Tubal Intraepithelial Lesions (STILs) | |||
| journal = Cureus | |||
| year = 2024 | |||
| volume = 16 | |||
| issue = 6 | |||
| pages = e62895 | |||
| doi = 10.7759/cureus.62895 | |||
| pmc = 11261535 | |||
| doi-access = free | |||
}}</ref> H&E staining shows mildly atypical tubal epithelium with largely preserved polarity. Immunohistochemistry demonstrates aberrant block-type p53 expression but a low Ki-67 proliferation index, insufficient for classification as serous tubal intraepithelial carcinoma (STIC).]] | |||
===Reporting=== | ===Reporting=== | ||
Example of a normal report in '''sterilization''': | Example of a normal report in '''sterilization''': | ||
{|class=wikitable | {|class=wikitable | ||
| {{Moderate-begin}} | | {{Moderate-begin}}Right and left fallopian tubes, {{Comprehensive-begin}}laparoscopic{{Comprehensive-end}} bilateral salpingectomy:{{Moderate-end}}<br>Complete cross-sections of histologically unremarkable fallopian tubes. | ||
|} | |} | ||
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|} | |} | ||
[[File:Histopathology of an ectopic pregnancy in a fallopian tube.jpg|thumb|Histopathology of an ectopic pregnancy in a fallopian tube, with chorionic villi and implantation site changes {{further|Products of conception}}.]] | |||
When done for '''ectopic pregnancy''', report any rupture, either from the gross report or from microscopy, for example: | |||
{|class=wikitable | |||
| Benign ruptured fallopian tube with ectopic products of conception, including degenerated immature chorionic villi and implantation site with fresh hemorrhage. | |||
|} | |||
{{further|Products of conception}} | |||
{{Bottom}} | {{Bottom}} | ||