Correlation of Cellular Patterns in Proliferate Epithelial Lesions of the Uterine Tube with Lesions in the Ovary; A Histopathologic Study

摘要

Abstract Objective: The study was conducted with the objective of correlating the proliferative epithelial lesions of the uterine tube with various benign and malignant ovarian pathologies. Design: The study included 62 specimens of panhysterectomy or hysterectomy with unilateral salpingo-oophorectomy with primary lesions in the ovary. Materials and Methods: The histologic changes in the uterine tubes were studied for three groups of epithelial abnormalities: benign tubal hyperplasia (BTH), atypical tubal hyperplasia (ATH), and carcinoma in situ (CIS), judged by the following characteristics: nuclear crowding, stratification of nuclei, loss of polarity, nuclear atypia, mitoses, papillae (papillary formation), solid proliferation, inflammation, and acidophilic metaplasia. Results: Proliferative epithelial lesions of one type or another were found in the great majority of cases with a lesion in the ovaries, varying from 50% (with germ cell tumors) to 100% (with sex cord stromal tumors). In cases with proliferative lesions, all cases (100%) of benign surface epithelial tumors and borderline surface epithelial tumor of the serous type were associated with benign hyperplasia; whereas lesions were of high grade (ATH and CIS) when found in association with malignant surface epithelial tumors. Conclusions: ATH and CIS (moderate to severe) were seen in association with malignancies in the ovary. ATH and CIS should be considered as distinct clinical entities. THE UTERINE TUBES ARE GENERALLY NOT EVALUATED with great diligence by the pathologist unless they are known or suspected to be the site of primary pathologic lesion. Therefore, the true frequency of proliferative epithelial lesions of the uterine tube is not known nor, nor is the extent of its relationship to lesions of the ovary or to primary adenocar-cinoma of the tube itself known with great certainty. Epithelial proliferations have been considered to be benign tumors of the uterine tube and are occasionally found during the microscopic examination of a specimen of tubal ligation or salpingectomy by some, whereas such proliferative epithelial lesions have been called "adenomatous hyperplasia" (ATH) or "carcinoma in situ" by others. These have also been divided into three groups: benign tubal hyperplasia (BTH), ATH, and CIS.