Fallopian tube in ectopic pregnancy
Author:
Mikael Häggström [note 1]
Fixation
Generally 10% neutral buffered formalin.
See also: General notes on fixation
Gross processing[1]
- Measure length and largest diameter
- Inspect the serosa, mainly for fibrin formations, hemorrahage and/or rupture
- Make a transverse cut through any dilated segment and note:
- Wall thickness
- Any lumen obstruction
- Any parovarial cysts
- In case of rupture, sample blood clots and any suspected pregnancy products (which usually arise from the rupture). Sample a transverse section from the rupture site.
- If there is no rupture, sample from any hemorrhaging spots, and from any intraluminal blood clots.
Try to identify and sample any egg sac. Sometimes a minimal embryo can be identified herein, which should be submitted separately.
See also: General notes on gross processing
Microscopic evaluation
Look for products of conception:
-
Products of conception in a tubal pregnancy. -
Tubal pregnancy with yolk sac inside a chorionic cavity.
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If found, check if the pregnancy is molar, as evidenced by:
- Heterogeneity in villous size with one one hand large, hydropic villi, and small, fibrotic villi on the other.
- Enlarged villi being irregularly shaped with scalloped borders and trophoblastic pseudoinclusions, and sometimes cistern formation
- Trophoblastic hyperplasia
-
Molar pregnancy: Mildly hydropic villus with scalloped margins and moderate trophoblastic proliferation without cytologic atypia.
-
Molar pregnancy: Closer view of invaginations in a mildly hydropic villus.
-
Molar pregnancy, as evidenced by prominent traophblastic hyperplasia.
In case of molar pregnancy, perform immunohistochemistry for p57. p57 negative cases with molar morphology are diagnosed as complete hydatidiform moles without genotyping. p57+ cases should be subjected to genotyping.[2]
If no embryonic tissue or villi can be histologically identified, submit any residual blood clots, as well as any additional pieces from macroscopically suspended portions of the tubal wall.[1]
Microscopy/Histopathology report
See also: General notes on reporting
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ 1.0 1.1 Monica Dahlgren, Janne Malina, Anna Måsbäck, Otto Ljungberg. Stora utskärningen. KVAST (Swedish Society of Pathology). Retrieved on 2019-09-26.
- ↑ Banet, Natalie; DeScipio, Cheryl; Murphy, Kathleen M; Beierl, Katie; Adams, Emily; Vang, Russell; Ronnett, Brigitte M (2013). "Characteristics of hydatidiform moles: analysis of a prospective series with p57 immunohistochemistry and molecular genotyping ". Modern Pathology 27 (2): 238–254. doi:. ISSN 0893-3952.
Image sources