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PubMed1994

Lymphogenous metastasis in the primary carcinoma of the fallopian tube.

The bad prognosis of primary Fallopian tube carcinoma (FTC) is mostly ascribed to early lymphogenous metastasis. Yet, there is a lack of information on the tumor size at which lymph node metastasis must be expected to occur. Our study was therefore designed to correlate the anatomopathologic substratum and the histologic results with the lymph node status. Data were obtained from 21 women who received primary surgery, during which additional total pelvic and para-aortic lymphadenectomy was performed as well. The "surgical" staging was compared to the final clinical staging after histologic inspection of the lymph nodes according to the FIGO classification. Lymph node metastases never occurred as long as the tumor was confined to the tube (stage I). Lymphogenous dissemination set in only after further, local expansion of the tumor, involving the ovaries, the peritoneum, or the uterus (surgical stage II); 3 of the 7 patients of surgical stage II had to be reclassified to stage III because of manifest lymph node metastases. After the onset of intra-abdominal or general metastasis (stage IV), lymph node metastases occurred significantly more often (P = 0.048). Due to the specific lymphatic drainage, lymphogenous metastasis must be expected to spread as far as to the para-aortic region even in the early stages. Highly differentiated tumors (G I) do not disseminate into the lymphatic system, not even in advanced stages, whereas anaplastic tumors (G II and III) metastasize relatively early. As soon as metastasis has occurred, prognosis of life diminishes markedly, but not significantly (49 versus 24 months, P = 0.19). Correct FTC-staging is obtained only on the basis of pelvic and para-aortic lymphadenectomy.

Adolescent↗
PubMed1980

[Clinical and pathological aspects of primary carcinoma of the fallopian tube (author's transl)].

A report is presented of 24 cases of primary carcinoma of the Fallopian tube, histologically confirmed between 1956 and 1971 at the laboratory of the 2nd Gynaecological Department, University of Vienna, Austria. All patients underwent surgery. Total hysterectomy and bilateral salpingo-ophorectomy was performed in 16 cases. All patients received radiotherapy after surgery. All patients in whom the carcinoma was not confined to the Fallopian tubes (stages II to IV) died within 5 years (average 2.6 years). Patients with stage I lesions survived longer than 5 years only in those cases with more highly differentiated carcinomas (grades I and II). Histological grading, therefore, seems to enable a more reliable prognosis of stage I carcinoma of the Fallopian tube.

Adult↗
PubMed1989

Mesodermal mixed tumor primary in the fallopian tube.

Mullerian mixed tumors, as a group, are uncommon. Only 27 cases of this tumor of the fallopian tube have been reported to date. We report the 28th case of mixed mesodermal tumor, originating in the fallopian tube. A 79-year-old woman had mistaken a bloody vaginal discharge for hematuria. Various examinations showed no evidence of malignancy. However, computerized tomography revealed an intrapelvic tumor. Laparotomy was performed, with a suspicion of tubal malignancy. The final pathologic diagnosis was mixed mesodermal tumor, originating in the fallopian tube. Postoperatively, the patient was placed on oral adjuvant chemotherapy for 34 months. At present, she is doing well. Though no definite conclusions regarding the best method of therapy can be reached, an aggressive mode of therapy is recommended. The primary therapy is surgery; however, surgery followed by chemotherapy may have a potential benefit.

Aged↗
PubMed1976

[The effect of extracts from Fallopian tube tissues, uterine fibromas and uterine adenocarcinomas on the growth and capacity for cell division of a human cell line].

Effects of the extracts prepared from tissues of fallopian tubes, uterine fibroid and uterine adenocarcinoma on mitotic activity and amitotic division in culture Tg33 were studied. Extracts with two protein concentrations, 25 and 100 mkg/ml, resp., were used. Differences were found between effects of extracts from malignant tissue and those of histologically unchanged fallopian tube extracts, and also the extract from tissues of uterine fibroid. The extracts from fallopian tubes removed during operation of the ovarian cyst and uterine fibroid (protein concentration 25 and 100 mkg/ml), and the extract of uterine fibroid (100 mkg/ml) caused the increase in mitotic activity. The extract from malignant tissues of adenocarcinoma (protein concentration 25 mkg/ml) and fallopian tubes (25 and 100 mkg/ml) caused no increase in the number of mitoses. The extract from tissues of uterine adenocarcinoma (protein concentration 100 mkg/ml) inhibited the number of mitoses in the culture. The above extracts effecting Tg33 cells caused the increase in the number of amitoses. The number of pathological mitoses did not increase under the influence of all the tested extracts.

Adenocarcinoma↗
PubMed1998

Adenocarcinoma of the fallopian tube: results of a multi-institutional retrospective analysis of 72 patients.

PURPOSE/OBJECTIVE: To determine the prognostic factors for predicting outcome of patients with adenocarcinoma of the fallopian tube and to evaluate the impact of treatment modalities in managing this uncommon disease. MATERIALS AND METHODS: A retrospective analysis of the tumor registries from 6 major medical centers from January 1, 1960 up to March 31, 1995 yielded 72 patients with primary adenocarcinoma of the fallopian tube. The Dodson modification of the FIGO surgical staging as it applies to carcinoma of the fallopian tube was utilized. Endpoints for outcome included overall and disease-free survival. Univariate analysis of host, tumor, and treatment factors was performed to determine prognostic significance, and patterns of failure were reviewed. RESULTS: The median age of the study cohort was 61 years (range 30-79 years). Stage distribution was 24 (33%) Stage I; 20 (28%) Stage II; 24 (33%) Stage III; and 4 (6%) Stage IV. Adjuvant chemotherapy was administered to 54 (75%) patients, and postoperative radiotherapy was employed in 22 (31%). In the latter treatment group, 14 (64%) had whole pelvic external beam irradiation, 5 (23%) whole abdominal radiotherapy, 2 (9%) P-32 instillation, and 1 (4%) vaginal brachytherapy alone. Chemotherapy was used in 67% of Stage I and in 79% of Stages II/III/IV disease (not significant); radiotherapy was more commonly employed in Stage I than in Stages II/III/IV (46% vs. 23%, p = 0.05). The 5-, 8-, 15-year overall and disease-free survival for the study patients were 44.7%, 23.8%, 18.8% and 27.3%, 17%, 14%, respectively. Significant prognostic factors of overall survival included Stage I vs. II/III/IV (p = 0.04) and age < or = 60 years vs. > 60 years at diagnosis (p = 0.03). Only Stage I vs. II/III/IV (p = 0.05) was predictive of disease-free survival. Patterns of failure included 18% pelvic, 36% upper abdominal, and 19% distant. For all patients, upper abdominal failures were more frequently found in Stages II/III/IV (29%) than in Stage I (7%) (p = 0.03). Relapses solely outside of what would be included in standard whole abdominal radiotherapy portals occurred for only 15% of patients (6 of 40) with failures. Furthermore, patients having any recurrence, including the upper abdomen, were more likely (p = 0.001) to die (45%) than those without any type of relapse (18%). CONCLUSION: This retrospective, multi-institutional study demonstrated the importance of FIGO stage in predicting the overall and disease-free survival of patients with carcinoma of the fallopian tube. Future investigations should consider exploring whole abdominal irradiation as adjunctive therapy, particularly in Stage II and higher.

Adenocarcinoma↗
PubMed1981

Fallopian tube carcinoma associated with retroperitoneal fibrosis.

Primary carcinoma of the fallopian tube is not frequent and, thus, the diagnosis rarely is made preoperatively. We described a patient who had back pain, an epigastric abdominal mass, a palpable right kidney and a palpable scalene node. Because of upper gastrointestinal problems 1 year previously, a gastric or pancreatic malignancy was suspected after a scalene node biopsy revealed moderately differentiated adenocarcinoma, with the primary tumor unknown. Excretory urography, retrograde pyelography and computerized axial tomography confirmed the diagnosis of retroperitoneal fibrosis. It was only by laparotomy that the primary tumor was identified. The etiology, incidence, natural history, treatment and prognosis of fallopian tube carcinoma and retroperitoneal fibrosis are discussed.

Adenocarcinoma↗
PubMed1994

Comparative immunohistochemical study of oestrogen and progesterone receptors in the fallopian tube and uterus at different stages of the menstrual cycle and the menopause.

Oestrogen and progesterone are known to require their corresponding steroid receptors to manifest structural and functional effects in the Fallopian tube, uterus and other target organs. This study compares cyclical variations of these receptors in the uterus and in different segments of the Fallopian tube in the same subjects using an immunocytochemical technique. The results show that in the Fallopian tube, isthmic and ampullary epithelial and stromal oestrogen receptors increased in the follicular phase to a peak at mid cycle and then declined in the late luteal phase. The intensity of immunostaining of oestrogen receptors was less in the Fallopian tube than in endometrial glandular epithelium. The fimbrial end demonstrated an opposite pattern of staining to other segments of the tube. Progesterone receptor immunostaining was more intense than that for oestrogen receptors in the follicular phase, and, whereas it disappeared completely from the endometrial glandular epithelium in the late luteal phase, positive staining was clearly visualized in the tubal epithelium and stroma and endometrial stroma at this stage of the menstrual cycle. These differences in the steroid receptor content may reflect the changing and different functional roles of these regions and may have important implications on human reproduction.

Endometrium↗
PubMed2003

Xanthelasma or xanthoma of the fallopian tube.

We report a case of a 24-year-old woman who presented with abdominal pain, a tense abdomen, and rebound tenderness. A vague, ill-defined mass was palpated, and an ultrasound examination revealed a cystic lesion in the left adnexal region. At laparotomy, a slightly dilated fallopian tube was seen and excised. Light microscopy showed intact fallopian tube mucosa, with a diffuse infiltrate of foam cells in the lamina propria. There were no associated inflammatory cells. The foam cells were positive for CD68 and negative for AE1/AE3. Discontinuous areas of the epithelium also showed epithelial cells with "foamy cytoplasm." These cells were negative for CD68 but positive for AE1/AE3. To our knowledge, this represents the first case of a fallopian tube xanthelasma that shows a resemblance to lesions encountered in the stomach. Fallopian tube xanthelasma must be distinguished from xanthogranulomatous salpingitis, which is associated with an inflammatory cell infiltrate, often including giant cells. However, this lesion may share pathogenetic similarities with xanthogranulomatous salpingitis, since both processes are mediated by inflammation.

Adult↗
PubMed2000

MR hysterosalpingography: protocol development and refinement for simulating normal and abnormal fallopian tube patency--feasibility study with a phantom.

PURPOSE: To develop and refine a pulse sequence and protocol for testing the feasibility of magnetic resonance (MR) hysterosalpingography in a phantom model. MATERIALS AND METHODS: A phantom simulating the uterus, fallopian tubes, and surrounding pelvic cavity was constructed. T2-weighted acquisition strategies-breath-hold fast spin-echo, rapid acquisition with relaxation enhancement (RARE), and haff-Fourier RARE-were refined to acquire sequential 70-mm coronal imaging volumes. Contrast agent was injected into the introducing catheter entering the os of the simulated uterus. Interacquisition interval, type of contrast agent (eg, sterile saline solution or water), and quantity of contrast agent (eg, 1-5 mL per acquisition) were varied. Digital image subtraction was used to enhance image quality. Images were qualitatively analyzed and rated good, fair, or poor for temporal resolution, spatial resolution, fallopian tube conspicuity, and free spill conspicuity. Once the technique was refine, the phantom was reconfigured to simulate unilateral and bilateral hydrosalpinx. RESULTS: The RARE sequence with an 8-second interacquisition interval and a 5-mL interacquisition of sterile water produced good images of the simulated fallopian tubes and free spill. Depiction of unilateral and bilateral hydrosalpinx was also reliably demonstrated. CONCLUSION: This study with a phantom model demonstrates the feasibility of MR hysterosalpingography to depict normal and diseased fallopian tubes.

Constriction, Pathologic↗
PubMed1997

Clear cell hyperplasia of the fallopian tube epithelium associated with ectopic pregnancy: report of a case.

A case of clear cell hyperplasia of the fallopian tube epithelium associated with ectopic pregnancy is described. The lesion was encountered in a 31-year-old woman who presented with abdominal pain and had a positive pregnancy test. Ultrasound examination disclosed an enlarged right fallopian tube. The patient underwent laparotomy, at which time the right fallopian tube was excised. On gross examination, a firm, 1.2 x 1 x 1-cm nodule almost obliterating the lumen of the tube and an abundant blood clot were present. On histologic examination, chorionic villi were found in the blood clot. The nodule was composed of epithelial cells that formed solid and glandular structures. The cells had clear cytoplasm and nuclei without atypia. The differential diagnosis included clear cell adenocarcinoma, but clear cell hyperplasia associated with pregnancy was diagnosed because of the absence of cytologic atypia and mitotic figures. The patient has had an uneventful postoperative follow-up period of 1 year.

Adenocarcinoma, Clear Cell↗
PubMed1984

Electron microscope studies of attachment to human fallopian tube mucosa by a gonococcal IgA1 protease deficient mutant and wild type parent.

Organ cultures of human fallopian tube were used to assess the potential role of gonococcal IgA1 protease in infection of mucosal tissue. A genetically cloned IgA1 protease deficient mutant and its wild type parent were used to infect fallopian tube organ cultures. The comparative rate and extent of attachment, invasion and damage to the organ cultures by the gonococcal mutant and its parent type were assessed by scanning and transmission electron microscopy and determined to be indistinguishable from one another. These results indicate that the lack of IgA1 protease does not compromise the gonococcus in its ability to infect previously uninfected human fallopian tube mucosa.

Fallopian Tubes↗
PubMed1995

New methods for transcervical cannulation of the fallopian tube.

Technological advances have led to major improvements in the design and application of Fallopian tube cannulation devices using the transcervical approach. Presently such cannulation systems are being used to overcome infertility disorders. These transcervical access systems are now able to displace debris that may block the tube, break down intraluminal adhesions or place egg, sperm or embryos in the tube to facilitate conception. Conversely, these same or modified devices could be used to place sclerosing agents or occlusive devices within the Fallopian tubes using similar transcervical access technology. Transcervical delivery systems incorporating a very fine endoscopic fiber have also been developed to visibly assess the inside lumen of the Fallopian tube using a transcervical approach. Such a system could be used to accurately identify specific sites in the tube for placement of such devices. The potential for placing permanent or temporary devices in the tube and the option of reversible sterilization may become a possibility in the future. One of the biggest obstacles against a wide distribution of these devices, particularly in third world countries, will be cost and the relative technical complexity in using them. These factors will need to be addressed more carefully in assessing the overall strategy of population control. The pressure on governments and international agencies to place more resources into population control may facilitate the accelerated development, application and cost containment of these new devices and delivery systems.

Cervix Uteri↗
PubMed2003

Wilms tumor gene immunoreactivity in primary serous carcinomas of the fallopian tube, ovary, endometrium, and peritoneum.

Wilms tumor gene (WT-1) expression has been reported in many human cancers, including most ovarian and peritoneal serous carcinomas, but has not been studied in carcinomas of the fallopian tube. In this study, the authors evaluated the immunohistochemical expression of WT-1 in serous carcinomas of the fallopian tube and compared their reactivity with that of ovarian, peritoneal, and endometrial serous carcinomas. All primary serous carcinomas of the fallopian tube (13 cases), ovaries (25 cases), and peritoneum (3 cases) were reactive with the WT-1 antibody, whereas all five primary endometrial serous carcinomas were nonreactive. WT-1 reactivity in an unknown primary serous carcinoma is therefore suggestive of an extrauterine site. The marked difference in WT-1 staining raises the possibility of genetic differences between serous carcinomas arising in the endometrium compared with those arising in the ovaries, fallopian tubes, and peritoneum.

Adult↗
PubMed1977

The microsurgical basis of Fallopian tube reconstruction.

A rational approach to the reconstruction of the Fallopian tube, blocked either intentionally or by disease processes, can only be made on the basis of sound anatomical and physiological understanding. It would accordingly not be logical to expect the tube to function normally again after too great a disorganization by sterilization procedures followed by traumatic restorative operations. It is therefore recommended that any sterilization should be carried out by a midtubal atraumatic Pomeroy method, tissue being conserved for possible future reconstruction, and that a proven microsurgical technique be utilized for the best results of reconstruction to be obtained. This paper briefly details the anatomy and physiology of the Fallopian tubes, evaluates a microsurgical tubal repair in the rabbit, reports a series of tubal repairs in women, and suggests a working protocol for future tubal surgery.

Adult↗
PubMed1995

The role of superoxide dismutase in the human ovary and fallopian tube.

OBJECTIVES: To investigate the localization of manganese superoxide dismutase (Mn-SOD) and copper-zinc superoxide dismutase (Cu, Zn-SOD) in the human ovary and fallopian tube, and to examine the role of superoxide radicals and SODs in the human ovulatory process. METHODS: Using immunohistochemical methods, we studied the localization of SODs in 22 human ovaries, in 18 fallopian tubes, and in aspirated granulosa cells. We measured, by enzyme-linked immunosorbent assay, the concentrations of SODs in follicular fluid taken from 94 IVF patients. RESULTS: Mn-SOD was found in granulosa, in theca and luteal cells and in fallopian tubes. Cu, Zn-SOD was localized in theca and luteal cells. The concentration of Cu, Zn-SOD in follicular fluid in the high-progesterone group (11.3 + 4.2 ng/ml) was significantly less than in the low-progesterone group (24.5 + 19.5) (p < 0.05). CONCLUSION: Mn-SOD and Cu, Zn-SOD have different localizations and actions in human ovaries and fallopian tubes. The superoxide radical-SOD system might play an important role in ovulation and in the luteal function of the human ovary.

Body Fluids↗
PubMed2007

Membrane progesterone receptor gamma: tissue distribution and expression in ciliated cells in the fallopian tube.

Non-genomic, rapid actions of steroids have long been known, suggesting the possible presence of non-classical steroid receptors. A membrane receptor for progestins (mPR) was recently described in the spotted seatrout, and transcripts of three related receptors (alpha, beta, and gamma) were subsequently identified in other species including human and mouse. To begin exploring the roles of mPRgamma in mammals, we have generated an antibody against this receptor. The specificity of the antibody was demonstrated by both overexpression and RNA interference experiments. Using the antibody, we show that mPRgamma is expressed in female mouse reproductive tissues such as ovary and fallopian tube, and also in the lung and liver of both sexes. Immunohistochemical studies revealed that mPRgamma is associated with the apical membrane of ciliated cells facing the lumen of the fallopian tube. The presence of mPRgamma in ciliated cells of the fallopian tube was also demonstrated in human samples. Rapid effects of progesterone on ciliary beat frequency in the fallopian tube have recently been reported. Together, this suggests a common role for mPRgamma in the regulation of ciliary activity in the fallopian tube and thus gamete transport in mammals. The presence of mPRgamma in lung and liver of mice suggests that the receptor mediates the actions of progesterone outside the reproductive tract as well.

Animals↗
PubMed1983

Fallopian tube microvasculature in the rabbit.

The microvascular architecture of rabbit Fallopian tube isthmic, ampullary and fimbrial regions was examined by the corrosion vascular cast-scanning electron microscope method. The aorta and inferior vena cava of virgin adult female rabbits (2.5-3.5 kg) were cannulated; after blood wash out, methacrylate casting medium was infused via the aorta. After plastic hardening, Fallopian tubes were excised, tissues corroded and casts prepared for scanning electron microscopy. The isthmic myosalpinx is encircled subserosally by an interlocking venous plexus. We suggest that a rise in pelvic venous pressure could lead to a decrease in isthmic luminal diameter and thus act as a sphincter contributing to the known delay in ovum transport at the ampullary isthmic junction. Stereo pairs of photomicrographs showed that isthmic plicae are supplied by arterioles which change little in diameter passing through the tubal wall. Near the apex of a fold, these arterioles terminate in a subepithelial capillary plexus which drains to deep mucosal and plical core venules. In contrast, the ampulla is supplied by smaller and less frequent arterioles. Frequent large venules extending high into the plicae drain the subepithelial capillary plexus. Based on this microvascular architecture, we suggest that the subepithelial capillary plexus of the apical region of the plicae probably contains high pressure blood in the isthmus and lower pressure blood in the ampulla. Therefore, plicae in these regions may be specialised for net luminal fluid secretion and absorption respectively, implying a role for the microvasculature in tubal transport by initiation or modification of fluid flow along the lumen.

Animals↗