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PubMed1998

Preoperative diagnosis of primary fallopian tube carcinoma.

INTRODUCTION: Transvaginal color and pulsed Doppler can detect areas of neovascularization within the tubal carcinoma and can distinguish it from other benign adnexal pathology. SUBJECTS AND METHODS. During a 7-year period eight cases of Fallopian tube carcinoma were detected using transvaginal color and pulsed Doppler. RESULTS: Transvaginal sonography revealed complex, sausage-shaped, and/or cystic structures in the adnexal region. Additional color Doppler examination depicted low vascular impedance (RI ranged from 0.29 to 0.40). Histopathology reported different types of Fallopian tube carcinoma. CONCLUSION: Transvaginal color Doppler may aid in diagnosis of Fallopian tube malignancy more reliably than using other costly diagnostic procedures.

Adenocarcinoma↗
PubMed1990

Selective osteal salpingography and transvaginal catheter dilatation in the diagnosis and treatment of fallopian tube obstruction.

Selective salpingography and transvaginal catheter dilatation were performed in 157 women with infertility to diagnose, localize, and classify obstructive diseases of the fallopian tubes and to correct obstruction of the proximal (uterine-end) tube. In 61 (39%) of the patients, the selective salpingograms showed patent tubes despite the fact that two previous hysterosalpingograms showed obstruction of the proximal (uterine-end) tube. Transvaginal catheter dilatation successfully recanalized the proximal portion of the tubes in 79 (82%) of 96 patients with obstructed tubes. In 18 of 25 with successful transvaginal catheter dilatation and 6-month follow-up salpingography, the tubes remained patent. Coexisting disease of the distal (ovarian-end) tubes was diagnosed in 29 (18%) of the patients. Pregnancy was achieved in 11 of the 157 patients (six in whom obstructions were corrected by transvaginal catheter dilatation and five in whom selective salpingograms showed patent tubes). There were no complications due to the procedure. The excellent diagnostic and therapeutic yield, lack of complications, and low cost justify the use of these percutaneous techniques to investigate female infertility and to treat obstruction of the uterine end of the fallopian tube.

Adult↗
PubMed1991

Chronic asymptomatic Chlamydia trachomatis colonization of the fallopian tubes during the peripartum period.

Antepartum cervical Chlamydia trachomatis infection is associated with an increased risk of peripartum maternal and neonatal morbidity. Chronic chlamydial salpingitis has been described in asymptomatic women. We studied the incidence of asymptomatic chlamydial colonization of the fallopian tubes during pregnancy, and the influence of such infection on the patients' clinical course, by culturing the fallopian tubes of 53 asymptomatic women who underwent tubal ligation in the immediate postpartum period. One patient had a positive chlamydial culture in one of her tubes, and two others had histologic evidence of acute and chronic salpingitis. These patients had no infectious morbidity during the antepartum, intrapartum, or postpartum periods. Our findings suggest that asymptomatic chlamydial colonization and inflammatory processes may exist in the fallopian tubes during the peripartum period.

Adolescent↗
PubMed1991

Reproductive outcome after microsurgery for proximal and distal occlusions in the same fallopian tube.

The reproductive outcome after microsurgery for both proximal and distal occlusions in the same fallopian tube has been reported in only small numbers of women. Our case series is in agreement with other series and shows that microsurgery for correction of both proximal and distal occlusions in the same fallopian tube yields only modest fertility and may predispose to ectopic tubal pregnancies.

Adult↗
PubMed1994

Primary carcinoma of the fallopian tube: a 20-year literature review.

Case series and important case reports of primary fallopian tube carcinoma published in the English literature from 1973 to 1992 are reviewed. Meta-analysis revealed a mean age of presentation of 56.7 years, with a nulliparity rate of 27.5 per cent and a mean parity of 1.7. Abnormal vaginal bleeding and discharge, and pelvic pain are the most common presenting symptoms. Despite developments in cytology, transvaginal ultrasound, and tumor markers, most cases remain undiagnosed preoperatively. In addition to direct intraperitoneal spread, early lymphatic spread is now recognized as a frequent cause of treatment failure. FIGO has recently released a staging classification for fallopian tube malignancy incorporating detailed surgical staging, which should allow uniformity and comparison between future series. Treatment regimes are empirically based on therapy for epithelial ovarian malignancy, but none have been subjected to controlled trials. Recent case series support extensive debulking surgery and adjuvant platinum-based combination chemotherapy for optimizing prognosis, although results from radiotherapy and hormonal therapy are largely disappointing. Promise is expressed in tumor markers and "second-look" laparotomy for monitoring disease response and planning management.

Adult↗
PubMed1991

Comparative morphometric study of the endometrium, the fallopian tube, and the corpus luteum during the postovulatory phase in normally menstruating women.

OBJECTIVE: To compare function and histologic structure of the corpus luteum (CL) to the morphology of the endometrium and the fallopian tube in normally menstruating women. DESIGN: Circulating steroid and luteinizing hormone (LH) levels were compared with CL steroid production in vitro and the histology of CL, endometrium, and the fallopian tube at four stages of the postovulatory phase (days LH +/- 0/LH+3, LH+4/LH+7, LH+8/LH+11, LH+12/onset of menstruation). SETTING OF PATIENTS: The study included 28 volunteers with proven fertility undergoing surgical sterilization timed in relation to the LH surge. INTERVENTIONS: Blood and urine samples for LH, progesterone (P), and estradiol assessment were obtained before (simultaneously with ultrasound examinations), during, and after operation. Biopsy specimens from CL, endometrium, and fallopian tube were taken at the surgical sterilization and subjected to morphometric analyses. MAIN OUTCOME MEASURES AND RESULTS: Significant correlation was found between the endometrial dating and the LH surge (r = 0.923) and between the dating of the endometrial and CL biopsies (r = 0.918). A significant correlation (P less than 0.01) existed between circulating P levels and two endometrial indices; the number of vacuolated cells (LH+4/LH+7) and the glandular diameter (LH+8/LH+11). CONCLUSION: In normally menstruating women, the endometrial biopsy is likely to closely gauge the CL activity provided the biopsy is timed in relation to the LH surge.

Adult↗
PubMed2006

Fallopian tube prolapse following hysterectomy.

OBJECTIVE: To investigate the clinical diagnosis, treatment, and prevention of fallopian tube prolapse (FTP) after hysterectomy. METHODS: A total of 7949 patients received hysterectomy from January 1983 to August 2005 in Peking Union Medical College Hospital, and 9 cases (including 1 case from other hospital) of FTP after hysterectomy were involved during this period. All of them were diagnosed according to pathological results and were followed up. The symptoms, diagnosis, and treatment of the FTP patients were analyzed retrospectively. RESULTS: The incidence of FTP after hysterectomy was 0.1% (8/7949), with the incidence of FTP after transabdominal hysterectomy being 0.06% (4/6229), after trans-vaginal hysterectomy being 0.5% (4/780), after laparoscopic assistant vaginal hysterectomy being 0 (0/940). There was no symptom in 3 cases. The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and the other 6 cases revealed red granulation tissue. All of them were excised vaginally and cauterized. The results were proved by pathological examination. No recurrence was reported during follow-up. CONCLUSIONS: FTP is a rare complication after hysterectomy. The prognosis is well after proper diagnosis and treatment Fixation of accessories onto the pelvic wall and complete peritonealization at the time of hysterectomy are the most important methods to prevent FTP after hysterectomy.

Adult↗
PubMed2006

[Clinical analysis of fallopian tube prolapse after hysterectomy].

OBJECTIVE: To investigate the clinical diagnosis, treatment and prevention of fallopian tube prolapse (FTP) after hysterectomy. METHODS: A total of 7949 patients received hysterectomy from 1983 to Aug 2005 in Peking Union Medical College Hospital, including 6229 cases of trans-abdominal hysterectomy (TAH), 780 cases of transvaginal hysterectomy (TVH), and 940 cases of laparoscopic assisted vaginal hysterectomy (LAVH). Nine cases (including 1 case from other hospital) of FTP after hysterectomy were analyzed retrospectively for their symptoms, diagnosis and treatment. All of them were diagnosed according to the results of histology and follow-up. RESULTS: The overall incidence of FTP after hysterectomy was 0.11% (9/7949). Incidence of FTP after trans-abdominal hysterectomy was 0.08% (5/6229), after vaginal hysterectomy 0.51% (4/780), and after laparoscopic assisted vaginal hysterectomy 0 (0/940). There were no symptoms in 3 cases, but the other 6 cases had symptoms. The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and red granulation tissue in the other 6 cases. All of them were excised vaginally and cauterized. The results were confirmed by histological examination. No recurrent cases were reported in follow up. CONCLUSIONS: FTP is a rare complication after hysterectomy. The prognosis is well after proper diagnosis and treatment. Salpingectomy or fixation of accessories into the pelvic wall and complete peritonealisation at the time of hysterectomy are important methods to prevent FTP after hysterectomy.

Adult↗
PubMed1996

Endometrioid carcinoma of the fallopian tube: a clinicopathologic analysis of 26 cases.

Twenty-six endometrioid adenocarcinomas of the fallopian tube that occurred in patients 37 to 85 (average 57) years of age are described. Most of the patients presented with symptoms related to a pelvic mass but nine tumors were incidental findings at the time of operation. All the neoplasms were unilateral. Eighteen tumors were Stage I, four Stage II, two Stage III, and two Stage IV. Two tumors were primary in the fimbriated end of the tube. On gross examination the typical appearance was that of a fusiform swelling of the tube which contained a predominantly intraluminal neoplasm up to 6 cm in greatest dimension. Six separate tumors were present in one case. Microscopic examination revealed that 14 tumors were typical endometrioid carcinomas with foci of squamous differentiation in 7 cases, spindle cells interpreted as epithelial cells in 4 cases, and a trabecular pattern in 1 case. One of these 14 tumors was composed almost exclusively of oxyphilic cells lining glands. Twelve tumors were characterized by a mostly solid proliferation of small closely packed cells punctured by numerous glands that varied from small to cystic, imparting a superficial resemblance to an adnexal tumor of probable Wolffian origin. Benign stromal osseous metaplasia was noted in two Wolffian-like and one typical endometrioid carcinoma. Five tumors were grade 1, 11 were grade 2, and 10 were grade 3. Follow-up information was available for 18 patients. Five with noninvasive Stage Ia-0 tumors (intraluminal, noninvasive masses) were without disease at 2 to 5 (average 3) years postoperatively. Two of three patients with Stage Ia1 tumors were alive without recurrence at 2 and 3 years postoperatively. One of two patients with Stage Ia2 disease for whom follow-up is available was alive without disease 1.5 years postoperatively and one died of other causes 11.2 years postoperatively. One patient with Stage Ic disease had recurrence of tumor at 2 years; four with Stage II disease were without disease at 1.5, 2, 3, and 8 years; one with Stage IIIa disease died with disease at 4 years; and one with Stage IV disease died with disease after 5 years. Two additional patients had fimbrial tumors [Stage I(f)]; one of them died with disease at 7 years, and the other was alive without disease at 8 years. This small series indicates that endometrioid carcinomas of the fallopian tube are characteristically noninvasive or only superficially invasive and have a generally favorable prognosis. This subtype of tubal carcinoma should be distinguished from the more common neoplasms of serous type and from those of various other cell types.

Adult↗
PubMed1993

Preoperative diagnosis of primary fallopian tube carcinoma by transvaginal ultrasound, cytological finding and CA-125.

Primary Fallopian tube carcinoma is rarely diagnosed preoperatively. We present the case of a 69-year-old woman with primary tubal carcinoma, which was diagnosed preoperatively on the basis of the cytological finding, characteristic features on transvaginal sonography, transvaginal color flow imaging and elevated CA-125. Transvaginal color Doppler imaging demonstrated the tumor revealed areas of neovascularization with characteristic low impedance (resistance index, 0.34 and pulsatility index, 0.62). Pathohistologic confirmation of the clearcell carcinoma has been done.

Adenocarcinoma, Clear Cell↗
PubMed1979

Amniotic cells in fetal Fallopian tubes.

In a dizygotic 25-week-old twin fetus the histologic examination of the Fallopian tubes disclosed an unusual finding: the bilateral salpingeal lumen was filled with amniotic cells. The latter were especially numerous in the ampulla which still had few folds and which therefore had a comparatively wide lumen. Amniotic cells and numerous granulocytes were present in stomach and duodenum, but no focus of perforation could be demonstrated. The clinical significance of the so far unknown resorptive potential of the Fallopian tubes and the possible late complications of prenatal intraperitoneal blood transfusions are discussed.

Amniotic Fluid↗
PubMed1995

[Primary carcinoma of the Fallopian tube. Presentation of two cases and review of the literature].

Two typical adenocarcinomas of the fallopian tube in a thirty two and thirty-eight-year-old patients are presented. Clinically both tumors were discovered after episodes of vaginal bleeding, abdominal pain and leukorrhen. Both patients were treated by total hysterectomy including removal of the ovaries and the fallopian tubes. One of the patients remains well after two and a half years postoperatively without signs and symptoms of tumor up to date. Microscopically the tumors were classified as poorly differentiated adenocarcinomas. A brief review of the pertinent literature, was done.

Adenocarcinoma↗
PubMed1989

Ciliary ultrastructure of respiratory and fallopian tube epithelium in a sterile woman with Kartagener's syndrome. A quantitative estimation.

Ciliary ultrastructure was studied and quantitatively estimated in a 27-year-old sterile woman suffering from complete KS. Ciliated epithelium was obtained from both nasal mucosa and a fallopian tube. Cilia from both locations were devoid of DA. Various MT abnormalities were found in 16 percent of respiratory epithelial and 21 percent of fallopian tube ciliary cross-sections. The abnormality related to radial spoke defect was frequently seen. The findings in the fallopian tubes were compared to three normal control cases. In these, DA were visible, and MT defects were mainly of excess or missing microtubules. The relevance of these findings to fertility is not clear.

Adult↗
PubMed2006

Uterus, fallopian tube, ovary and vagina-sparing laparoscopic cystectomy: technical description and results.

OBJECTIVES: The purpose of our study was to demonstrate, describe, and assess the results of the technique of laparoscopic cystectomy sparing the uterus, fallopian tubes, ovaries, and vagina. PATIENTS AND METHODS: Between July 2004 and December 2005, 13 women with neurogenic vesical dysfunction (mean age: 53.3+/-13.0 yr) underwent laparoscopic cystectomy sparing the uterus, fallopian tubes, ovaries, and vagina. A noncontinent transileal Bricker diversion was performed extracorporeally in each case. Parameters studied were the pre-, peri- and postoperative data. RESULTS: Mean duration of the operation was 325+/-36 min, and mean blood loss was 323.1+/-246.3 ml. No conversion was required. One perioperative complication was observed: a tear in a branch of the right hypogastric vein, which was sutured under laparoscopy. One patient was transfused during surgery (2 units of blood). No early or late postoperative complications were observed. One patient required transfusion of 2 units of red blood cell concentrate on the first day after surgery. None of the patients required opiate analgesia in the postoperative period. The analgesic regimen used was paracetamol and nefopam in all cases. The pain score on an analogic visual scale was less than 4 in all cases. Resumption of transit was not delayed in any of the patients. Mean hospital stay was 11.6+/-1.9 d. Over an average follow-up of 7.4+/-5.4 mo, none of the patients developed late complications. Before surgery, 77% of the women were sexually active; 80% of them were sexually active 4 mo after the surgery. CONCLUSIONS: Laparoscopic cystectomy sparing the uterus, fallopian tubes, ovaries, and vagina is feasible. This operation has low morbidity and requires only a limited stay in hospital.

Adult↗
PubMed1998

Regional influences of the fallopian tubes on the rate of boar sperm capacitation in surgically inseminated gilts.

Aliquots of ejaculated boar semen containing known numbers of spermatozoa were deposited into the caudal isthmus or rostral ampulla of the Fallopian tubes of gilts at, or immediately after, ovulation to assess regional influences on the rate of capacitation. Eggs were recovered during a second intervention 4, 5, 6 or 7 h after surgical insemination and were examined by phase-contrast microscopy. Results were obtained from ten animals in each of the 4-, 5- and 6-h groups and from eight animals in the 7-h group. With two exceptions, fertilized eggs were not recovered until 6 h after insemination into the isthmus, the proportion (45.6%) being significantly greater than the corresponding figure (1.4%) for ampullary insemination (P < 0.001). Similarly, the proportion of fertilized eggs recovered 7 h after insemination into the isthmus (58.7%) was significantly greater than after ampullary insemination (21.9%; P < 0.01). Numbers of spermatozoa associated with the zona pellucida remained low in all these instances, with mean figures per egg ranging from 0.3 to 3.8. Insemination into the isthmus gave a 1-2 h advantage in fertilization compared with insemination into the ampulla. Although relative rates of sperm cell progression to the site of fertilization may have contributed to this, there is strong evidence that rates of capacitation differ significantly in the respective portions of the Fallopian tube. Therefore, attention was focused on: (1) the viscous glycoprotein secretion in the caudal isthmus acting to remove seminal plasma from the sperm surface; and (2) the phase of sperm head binding to the isthmus epithelium. Gradients in local endocrine modulation by the adjacent ovary offer one explanation for the functional specialization of different regions of the Fallopian tubes.

Animals↗
PubMed2002

Peritoneal fluid, endometriosis, and ciliary beat frequency in the human fallopian tube.

Endometriosis and infertility are known to be associated, but it is unclear whether endometriosis causes infertility. We used contrast analogue enhancement to study the effect of peritoneal fluid from women with early stage endometriosis on the ciliary beat frequency of human fallopian tube epithelium. We obtained peritoneal fluid from six women with early stage endometriosis and from six fertile women with no evidence of endometriosis to use as controls. Fallopian tubes from hysterectomy specimens were collected from 17 women. The difference in ciliary beat frequency between fallopian tubes exposed to peritoneal fluids of women with and without endometriosis increased with the duration of incubation (mean difference at 24 h 1.35 Hz, 95% CI 0.94-1.75, p=0.01). At 24 h, ciliary beat frequency was significantly lower in the incubations with peritoneal fluid from women with endometriosis than controls (4.29 [0.15] vs 5.64 Hz [0.15], respectively, p=0.001). Impairment of ciliary action in women with endometriosis might reduce fertility.

Adult↗
PubMed1995

Estrogen induces epidermal growth factor (EGF) receptor and its ligands in human fallopian tube: involvement of EGF but not transforming growth factor-alpha in estrogen-induced tubal cell growth in vitro.

We studied the estrogen-dependent expression of epidermal growth factor (EGF), transforming growth factor (TGF) alpha, and EGF receptor gene transcripts in human fallopian tubes in vivo and in vitro. Competitive polymerase chain reaction (PCR) was performed on the fallopian tube RNA samples from the postmenopausal women with or without estrogen replacement. Amounts of EGF, TGF alpha, and EGF receptors gene transcripts in the estrogen-treated group (n = 3) were significantly (P < 0.01) more than those in the untreated group (n = 3). Competitive PCR also showed that EGF, TGF alpha, and EGF receptor gene transcripts level in tubal cells were increased by estrogen in vitro: messenger RNA levels of these factors were significantly (P < 0.01, n = 3) increased in cells incubated with 10(-8) M estrogen compared with those in cells without estrogen treatment. We studied whether EGF and/or TGF alpha is involved in the estrogen-induced tubal cell growth in vitro. Estrogen enhanced the [3H]-thymidine incorporation into the cell in dose- and time-dependent manners in culture: estrogen treatment for more than 12 h significantly (P < 0.05) enhanced the [3H]-thymidine incorporation into the cell at 10(-8) M. The estrogen-induced cell growth was observed in association with the increase in EGF, TGF alpha, and EGF receptor messenger RNA levels by estrogen. If the EGF and/or TGF alpha is involved in the cell growth, then the estrogen-induced cell growth should be suppressed by blocking the action of EGF and/or TGF alpha. Therefore, we examined the effects of neutralizing monoclonal antibodies against EGF, TGF alpha, and EGF receptors. Anti-EGF antibody significantly reduced the estrogen-induced increase in [3H]-thymidine incorporation, whereas anti-TGF alpha antibody failed to show the effect. Anti-EGF receptor antibody showed a significant suppressive effect on the estrogen-induced increase in [3H]-thymidine incorporation. Moreover, the growth inhibitory effect by 1 microgram/ml anti-EGF was restored by 10(-8) M EGF but not by TGF alpha even at 10(-6) M. All these data suggest that estrogen induces EGF and TGF alpha/EGF receptors in the human fallopian tube and that EGF but not TGF alpha may be involved in the estrogen-induced human tubal cell growth in vitro.

Antibodies, Monoclonal↗
PubMed2000

Structural and cell surface antigen expression in the rete ovarii and epoophoron differs from that in the Fallopian tube and in endometriosis.

AIMS: We compared the immunohistochemical profiles of the rete ovarii and endometriosis in order to identify a panel which distinguishes between these structures. The immune profiles of the epoophoron, Fallopian tube and ovarian surface epithelium were also studied. MATERIALS AND METHODS: Twenty-four women with no evidence of endometriosis and seven who had endometriosis in the uterine adnexae were studied using nine antibodies to intermediate filament proteins and cell surface markers. None of the structures studied shared an identical profile of immunohistochemical reaction. The immunoprofile of endometriosis showed some similarities to that of the Fallopian tube, but differed from that of the rete ovarii, epoophoron and ovarian surface epithelium CONCLUSIONS: A panel including Ca-125, epithelial membrane antigen and the epithelial glycoprotein BerEp4 would permit the distinction between endometriosis and the rete ovarii in problematic cases. The study showed some commonality in reaction between endometriosis and the Fallopian tube which indicates that they may share a common (paramesonephric) origin. There was little commonality in the immunoprofile of endometriosis and the ovarian surface epithelium implying that endometriosis is unlikely to develop as a result of serosal metaplasia.

Antigens, Surface↗