D efinition — A constellation of findings in the ovary during gestation. Clinical Features Epidemiology Related to the pregnancy state. Linked to the effects of gonadotropins on the ovarian cortex. Can be particularly pronounced during multiple-gestation pregnancies and hydatidiform moles. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

PITFALL D efinition — A benign sectioning artifact that can be mistaken for neoplasia. Clinical Features Epidemiology Reproductive-age women. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition — A low-grade neoplasm that is thought to arise in the mesonephric remnants of the broad ligament. Clinical Features Epidemiology Female adnexal tumors of (probable) wolffian origin (FATWOs) are rare neoplasms, and no clinical or demographic associations have yet been made regarding their origin. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you…

D efinition — Intraepithelial neoplasms of presumed nontubal origin. Clinical Features Epidemiology Uncommon but a function of the thoroughness to which the tube is examined. Can be seen with both gynecologic and nongynecologic tumors. Mucosal involvement will be seen in about one third of cases where the tube is involved. Colon and breast are the most common sites of origin. You’re Reading a Preview Become a…

D efinition — Adenocarcinoma arising in the tubal mucosa. Clinical Features Epidemiology Historically a small fraction (5% or less) of pelvic serous carcinomas relative to the ovary; however, with the attention being paid to the distal tube (using the section and extensively examine the fimbriated end [SEE-FIM] protocol) as a source of many high-grade serous carcinomas, the incidence is presumed to be much higher. Linked to…

D efinition — Psammous calcifications in the lumen and plica of the fallopian tube. Clinical Features Epidemiology Uncommon. Approximately one half are associated with low-grade serous tumors of the ovary (borderline or low-grade malignancies). You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

D efinition — A procedure designed to remove the tubes and ovaries prior to the development of malignancy in women at high risk for ovarian cancer (BRCA1/2 germ-line mutations). Clinical Features Epidemiology Heterozygous germ-line mutations in BRCA1 or BRCA2 occur in approximately 1 in 400 women in the general population and 1 in 40 women of Ashkenazi Jewish descent. Lifetime risk of a pelvic fimbrial ovarian…

D efinition — Intramucosal (noninvasive) serous carcinoma. Undisputable origin of pelvic serous cancer when found in isolation or with early invasion. A plausible candidate of origin when found in association with advanced disease. Clinical Features Epidemiology Serous tubal intraepithelial carcinoma (STIC) is rare, found in less than 1 : 1000 routine salpingectomies. It is found in from 1% to 12% of tubes removed during risk reduction salpingo-oophorectomy (RRSO)…

D efinition — An increase in thickness of the epithelial layer, occasionally forming papillary tufts within the tubal lumen. Clinical Features Epidemiology Papillary hyperplasia is an uncommon entity, and no associations have been made regarding incidence or predisposing factors. They have some resemblance to borderline serous tumors and have been proposed as a potential precursor to these tumors. However, they are not associated with most borderline…

D efinition — A serous intraepithelial neoplasm of uncertain risk that does not fulfill the criteria for serous tubal intraepithelial carcinoma (STIC). Clinical Features Epidemiology Low-grade serous tubal intraepithelial neoplasia (STIN) is synonymous with a proliferation produced when there are both a mutation and an inactivation of p53 and is similar to STIC. Like STICs, STINs are uncommon, found in less than 1 : 500 routine salpingectomies. It…

D efinition — A limited clonal expansion of secretory cells associated with mutations in p53 exhibiting minimal or atypia. Seen as perhaps the very first step in serous carcinogenesis in the tube; often termed a “latent precursor” to pelvic serous carcinoma. Clinical Features Epidemiology p53 signatures exhibit features consistent with very early or latent serous cancer precursors. They are common (up to 70%) in thoroughly sectioned…

D efinition — Benign, self-limited clonal proliferations of tubal secretory-type cells with variable ciliation. Clinical Features Epidemiology and Pathogenesis Secretory cell outgrowths (SCOUTs) are common proliferations seen most commonly in the sixth and seventh decades of life but may be found earlier. They are increased somewhat in fallopian tubes of women with borderline or malignant serous tumors. However, whether they have a direct relationship to serous…

D efinition — A benign neoplasm of the distal tube. Clinical Features Epidemiology Adenofibromas are thought to be relatively common entities within the fallopian tube and are found predominantly within the fimbriated end of the tube. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

PITFALL D efinition — Hormonally induced changes that occur within the epithelium of the gynecologic tract (typically secondary to pregnancy). Clinical Features Epidemiology Arias-Stella effect is most commonly seen in the background of pregnancy; however, it can be seen in any case of hormonal alteration (whether exogenous or endogenous). You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become…

D efinition — Mechanical interruption of the adnexal arterial and/or venous blood flow by mechanical factors. Clinical Features Epidemiology Rare (reported in as few as 1 in every 1.5 million women), can occur at any age but usually in reproductive-age women. Most commonly seen with pregnancy, hydrosalpinx, ovarian cysts, tubal ligation, and benign tumors. Uncommonly associated with malignancies. Caused by rotation on the vascular pedicle. Fallopian…

D efinition — Granulomatous inflammation of the fallopian tube. Clinical Features Epidemiology Granulomatous salpingitis is uncommon. The granulomatous inflammation may be secondary to infectious causes ( Mycobacterium tuberculosis , actinomyces, and parasitic infections) or noninfectious causes (sarcoid, Crohn's disease, or foreign-body giant cell reaction). You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a…

D efinition — A proliferation of smooth muscle with accompanying epithelium in the fallopian tube, analogous to adenomyosis/adenomyoma seen within the uterus. Clinical Features Epidemiology Salpingitis isthmica nodosum (SIN) is a relatively common phenomenon seen in up to 11% of thoroughly examined fallopian tubes. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a…

D efinition — The chronic phase of pelvic inflammatory disease. Clinical Features Epidemiology Follicular salpingitis is the chronic phase of pelvic inflammatory disease, which is common in the United States (as well as the remainder of the world). The majority of cases happen in young adults and are related to sexual activity. The majority of the remaining cases are secondary to instrumentation or intrauterine device use.…

D efinition — An admixture of inflammatory cells and histiocytes within the fallopian tube. Clinical Features Epidemiology Xanthogranulomatous salpingitis is an uncommon entity. It is most commonly seen in association with pelvic inflammatory disease, extensive endometriosis, and intrauterine contraceptive devices. Infection with one of a variety of coliform bacteria likely plays a role in some cases. Rare cases have been associated with contrast agents. You’re Reading…

D efinition — Accumulation of histiocytic cells within the fallopian tube in association with pelvic endometriosis. Clinical Features Epidemiology Pseudoxanthomatous salpingiosis is an uncommon entity that may be found in association with endometriosis. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here