Pseudocarcinomatous hyperplasia of the fallopian tube associated with salpingitis. A report of 14 cases.
We describe 14 cases of pseudocarcinomatous changes in the fallopian tube characterized by florid epithelial hyperplasia and in half the cases mesothelial hyperplasia and associated with chronic salpingitis. The patients' ages ranged from 17 to 40 years. Seven had clinical evidence of pelvic inflammatory disease. Tubal enlargement or thickening were observed in 12 cases and pyosalpinx, tubo-ovarian abscesses, or hydrosalpinx, in six cases. All cases showed no gross evidence of tumor. The reactive atypical hyperplasia mimicked carcinoma microscopically because of a cribriform pattern, penetration of the tubal wall by hyperplastic epithelium, florid mesothelial hyperplasia, or a combination of these findings; epithelial papillae were present in the lymphatics in two cases. In five cases, an erroneous microscopic diagnosis of carcinoma had been made or seriously entertained initially, and one patient underwent a radical hysterectomy as a result. The typically young age of the patients, absence of a gross tumor, presence of severe chronic inflammation, lack of solid epithelial proliferation, mildness of nuclear atypia, and paucity of mitotic figures facilitated the differential diagnosis. Nine patients for whom follow-up information was available had no recurrence of tubal disease.