Difference between revisions of "Fallopian tubes"

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{{Top
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<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]]
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{{Comprehensiveness}}</noinclude>
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==Gross processing==
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[[File:Gross pathology of paratubal cysts.jpg|thumb|'''[[Paratubal cysts]]''' can be ignored if incidentally found.]]
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{{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>
  
{{Comprehensiveness}}
 
==Gross processing==
 
 
;For sterilization:
 
;For sterilization:
 
*'''Measure''' length and average diameter of each tube
 
*'''Measure''' length and average diameter of each tube
 
*Serially '''section''' at 3-4 mm intervals,<ref name=rcpa>{{cite web|url=https://www.rcpa.edu.au/Manuals/Macroscopic-Cut-Up-Manual/Gynaecology-and-perinatal/Ovary-and-fallopian-tube-benign-setting|title=Ovary and fallopian tube -benign setting|website=Royal College of Pathologists of Australasia|author=Kerryn Ireland-Jenkin and Marsali Newman|accessdate=2020-10-16}}</ref> or 2-3 mm if suspected malignant (including BRCA mutation).<ref name="CrumMckeon2012">{{cite journal|last1=Crum|first1=Christopher P.|last2=Mckeon|first2=Frank D.|last3=Xian|first3=Wa|title=The Oviduct and Ovarian Cancer|journal=Clinical Obstetrics and Gynecology|volume=55|issue=1|year=2012|pages=24–35|issn=0009-9201|doi=10.1097/GRF.0b013e31824b1725}}</ref> Submit  
 
*Serially '''section''' at 3-4 mm intervals,<ref name=rcpa>{{cite web|url=https://www.rcpa.edu.au/Manuals/Macroscopic-Cut-Up-Manual/Gynaecology-and-perinatal/Ovary-and-fallopian-tube-benign-setting|title=Ovary and fallopian tube -benign setting|website=Royal College of Pathologists of Australasia|author=Kerryn Ireland-Jenkin and Marsali Newman|accessdate=2020-10-16}}</ref> or 2-3 mm if suspected malignant (including BRCA mutation).<ref name="CrumMckeon2012">{{cite journal|last1=Crum|first1=Christopher P.|last2=Mckeon|first2=Frank D.|last3=Xian|first3=Wa|title=The Oviduct and Ovarian Cancer|journal=Clinical Obstetrics and Gynecology|volume=55|issue=1|year=2012|pages=24–35|issn=0009-9201|doi=10.1097/GRF.0b013e31824b1725}}</ref> Submit  
*'''Submit''' at least one circumferential transverse section. If only a segment of the tube of less than <5mm{{Comprehensive-begin}}, ink the surgical cut surfaces and{{Comprehensive-end}} submit all tissue.<ref name=rcpa/>
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*'''Submit''' 1 {{Moderate-begin}}or 3{{Moderate-end}} circumferential transverse sections. If the specimen is only a segment of the tube of less than <5mm{{Comprehensive-begin}}, ink the surgical cut surfaces and{{Comprehensive-end}} submit all tissue.<ref name=rcpa/>
  
 
Example gross report:
 
Example gross report:
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==Microscopic examination==
 
==Microscopic examination==
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[[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.
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===Tumor===
 
===Tumor===
 
The most common tumor of the fallopian tubes is '''adenomatoid tumor''':<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>
 
The most common tumor of the fallopian tubes is '''adenomatoid tumor''':<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=200>
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<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.
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===Reporting===
 
===Reporting===
Example of a normal report in sterilization:
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Example of a normal report in '''sterilization''':
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{|class=wikitable
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| {{Moderate-begin}}Right and left fallopian tubes, laparoscopic bilateral salpingectomy:{{Moderate-end}}<br>Complete cross-sections of histologically unremarkable fallopian tubes.
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|}
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When included in a '''[[uterus]]''' specimen, normal tubes and ovaries may simply be mentioned as:
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{|class=wikitable
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| Bilateral fallopian tubes and ovaries, unremarkable.
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|}
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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}}.]]
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When done for '''ectopic pregnancy''', report any rupture, either from the gross report or from microscopy, for example:
 
{|class=wikitable
 
{|class=wikitable
| {{Moderate-begin}}Left and right fallopian tubes, laparoscopic bilateral salpingectomy:{{Moderate-end}}<br>Complete cross-sections of histologically unremarkable fallopian tubes.
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| Benign ruptured fallopian tube with ectopic products of conception, including degenerated immature chorionic villi and implantation site with fresh hemorrhage.
 
|}
 
|}
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{{further|Products of conception}}
 
{{Bottom}}
 
{{Bottom}}

Revision as of 16:46, 19 June 2022

Author: Mikael Häggström [note 1]

Presentations

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Gross processing

Paratubal cysts can be ignored if incidentally found.

(Look in the history for any intra-fallopian coils (Essure devices).)[note 2]

For sterilization
  • Measure length and average diameter of each tube
  • Serially section at 3-4 mm intervals,[1] or 2-3 mm if suspected malignant (including BRCA mutation).[2] Submit
  • Submit 1 (or 3) circumferential transverse sections. If the specimen is only a segment of the tube of less than <5mm((, ink the surgical cut surfaces and)) submit all tissue.[1]

Example gross report:

(A. Labeled - __. The specimen is received in formalin and consists of) two fimbriated segments of fallopian tube measuring __ cm in length and __ cm in average diameter. On sectioning, each displays a patent lumen. No gross abnormalities are identified. The tubes are unoriented. The specimen is serially cross-sectioned and representative sections are submitted for microscopic examination in two cassettes.

Microscopic examination

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.
  • Check for patency of the lumen.

Tumor

The most common tumor of the fallopian tubes is adenomatoid tumor:[3]

Reporting

Example of a normal report in sterilization:

(Right and left fallopian tubes, laparoscopic bilateral salpingectomy:)
Complete cross-sections of histologically unremarkable fallopian tubes.

When included in a uterus specimen, normal tubes and ovaries may simply be mentioned as:

Bilateral fallopian tubes and ovaries, unremarkable.
Histopathology of an ectopic pregnancy in a fallopian tube, with chorionic villi and implantation site changes Further information: Products of conception .

When done for ectopic pregnancy, report any rupture, either from the gross report or from microscopy, for example:

Benign ruptured fallopian tube with ectopic products of conception, including degenerated immature chorionic villi and implantation site with fresh hemorrhage.

Further information: Products of conception

Notes

  1. 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.
  2. 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.

Main page

References

  1. 1.0 1.1 Kerryn Ireland-Jenkin and Marsali Newman. Ovary and fallopian tube -benign setting. Royal College of Pathologists of Australasia. Retrieved on 2020-10-16.
  2. Crum, Christopher P.; Mckeon, Frank D.; Xian, Wa (2012). "The Oviduct and Ovarian Cancer ". Clinical Obstetrics and Gynecology 55 (1): 24–35. doi:10.1097/GRF.0b013e31824b1725. ISSN 0009-9201. 
  3. 3.0 3.1 Nicole Riddle, Jamie Shutter. Fallopian tubes & broad ligament - Fallopian tube tumors - Adenomatoid tumor. Pathology Outlines. Topic Completed: 1 September 2013. Minor changes: 13 December 2019

Image sources