Pathologic quiz case: an incidental finding in the fallopian tube. Fallopian tube, left, tubal ligation: metaplastic papillary tumor of fallopian tube.
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Adult↗
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Scanning electron microscopy of the human fallopian tube.
Fallopian tubes from women of reproductive and postmenopausal ages were examined by scanning electron microscopy. The surface topography of these Fallopian tubes is described and illustrated.
Adult↗
[Spontaneous healing after transverse resection of the fallopian tubes: observations on operated fallopian tube pregnancies].
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Animals↗
Proximal fallopian tube occlusion: diagnosis and treatment with transcervical fallopian tube catheterization.
Transcervical fallopian tube catheterization (TFTC) was performed in 22 infertile patients with bilateral fallopian tube obstruction and a mean duration of infertility of 3.3 years. A high prevalence of previous ectopic pregnancy (n = 8, 36%), tubal ligation and/or reconstruction (n = 5, 23%), spontaneous or therapeutic abortion (n = 6, 27%), and previous intrauterine device use (n = 14, 64%) was noted. The authors successfully catheterized 40 (98%) of 41 tubes without serious complication and visualized the distal tube in 36 (88%) of 41 tubes. Free spill in at least one tube was seen in 17 (77%) of 22 patients. Nineteen patients had a history of previous laparoscopy or laparotomy for tubal disease, in 16 of whom laparoscopic results were available for review. Retrospectively, in 15 (94%) of 16 patients all clinically relevant abnormalities would have been detected by means of TFTC alone. Five patients conceived, three with intrauterine and two with ectopic pregnancies. Patients with intrauterine pregnancies had normal-appearing tubes after TFTC, while those with ectopic pregnancies had residual tubal abnormalities after recanalization. TFTC is a safe, accurate diagnostic procedure that provides more information than hysterosalpingography and, in most cases, as much or more information about the fallopian tubes than laparoscopy.
Adult↗
Fallopian tube disease: limited value of treatment with fallopian tube catheterization.
PURPOSE: Therapeutic role of fallopian tube catheterization was prospectively studied in patients with bilateral fallopian tube obstruction. MATERIALS AND METHODS: Catheterization was performed in 42 patients with bilateral obstruction; 36 of the patients (67 fallopian tubes) underwent recanalization. RESULTS: Fifty-two tubes with 54 proximal obstructions were successfully recanalized (technical success rate, 96%), 36 with selective catheterization and 16 with coaxial techniques. Among 13 tubes blocked at the distal portion of the tube, six tubes were negotiated. Perforation or subintimal injury occurred in three tubes, and one patient eventually had a tubal pregnancy. During follow-up of 3 months to 4 years, five patients had conceived, including the patient with a tubal pregnancy and one patient who experienced spontaneous abortion during the first trimester. CONCLUSION: Fallopian tube catheterization is technically highly successful and diagnostically useful. However, its role in treating fallopian tube diseases is limited, and patients with distally blocked tubes are not good candidates for this procedure.
Adult↗
HER-2 oncogene is not amplified in primary carcinoma of the fallopian tube. Austrian Cooperative Study Group for Fallopian Tube Carcinoma.
73 women suffering from primary carcinoma of the fallopian tube underwent surgical excision of their tubes. The tissue was embedded in paraffin and investigated for HER-2 oncogene amplification with a quantitative polymerase chain reaction method. DNA could be extracted and successfully prepared in 65/73 samples. None of the tissue samples exhibited amplified the HER-2 oncogene. Data suggest that the HER-2 oncogene does not play a role in tumor transformation and progression in fallopian tube carcinomas. This contrasts with observations in ovarian carcinomas, with which fallopian tube carcinomas share many clinical, histological and biochemical similarities.
Base Sequence↗
Expression of insulin-like growth factor-I (IGF-I) in the rat fallopian tube: possible autocrine and paracrine action of fallopian tube-derived IGF-I on the fallopian tube and on the preimplantation embryo.
Recent studies have indicated that growth factors such as insulin-like growth factors (IGFs) increase the growth rate of cultured preimplantation embryos. We therefore hypothesized that the fallopian tube may produce IGFs which in turn participate in the regulation of preimplantation embryo development in vivo. In the present study we examined the expression of IGF-I in the fallopian tube. We demonstrated that IGF-I transcripts (7.0, 1.7, and 1.2-0.8 kilobases) were abundant in the fallopian tube. Immunoreactive IGF-I was most abundant in the epithelial cells in the fallopian tube, and IGF-I messenger RNA (mRNA) was detected in the luminal region of the fallopian tube. A solution hybridization assay was used to examine the regulation of IGF-I mRNA. The abundance of IGF-I transcripts changed markedly during the 4-day estrous cycle with the highest levels on the day of proestrus. The increase in IGF-I mRNA between the day of diestrus II and the day of proestrus was 4-fold (P < 0.01). The pattern of IGF-I mRNA expression in the fallopian tube resembled the pattern of ovarian estrogen production during the estrous cycle. The level of IGF-I mRNA decreased after hypophysectomy. The expression of IGF-I mRNA in the fallopian tube was dose-dependently regulated by estradiol, and a single sc injection of estradiol [5 micrograms/100 g body wt (BW)] increased the IGF-I mRNA in a time-dependent manner with a significant increase after 3 h (P < 0.01). The lowest estradiol dose tested (0.1 microgram/100 g BW) increased the expression after 6 h, whereas progesterone (5 micrograms/100 g BW) was ineffective. The presence of embryos in the fallopian tube did not statistically significantly influence the abundance of IGF-I transcripts as measured with a solution hybridization assay on RNA extracted from whole fallopian tubes. In order to determine possible targets for fallopian tube-derived IGF-I we examined the expression of IGF-I receptor mRNA. Northern blot analysis revealed that an 11-kilobase IGF-I receptor transcript was expressed in the fallopian tube. Using a reverse transcriptase-polymerase chain reaction, IGF-I receptor mRNA was also detected in the eight-cell but not two-cell preimplantation embryo. The present study demonstrates that IGF-I is produced in the fallopian tube and its expression is regulated by estradiol. Both the fallopian tube and the eight-cell preimplantation embryo express IGF-I receptors and are therefore potential target tissues.
Animals↗
Case report: Bone metastases from fallopian tube carcinoma.
Fallopian tube carcinoma is a rare gynecologic tumor that has metastasized to bone in only one documented case. This case report is of a 56-year-old woman with a primary fallopian tube cancer metastasizing to her right femur and rib cage. This patient was referred to our orthopaedic department from her gynecologic oncologist. A total abdominal hysterectomy and bilateral salpingectomy and oophorectomy revealed fallopian tube cancer. After surgery, the patient had progressive right thigh pain with activity. Radiographs of the femur showed a lytic lesion in the right proximal femur diaphysis with erosion of the medial cortex. We did an open biopsy and curettage of the lesion and intramedullary rod placement. The biopsy confirmed a metastatic lesion arising from the primary fallopian tube cancer. Currently, the patient is recovering and is receiving radiation and chemotherapy. In this case report, we discuss the presentation and treatment course of the patient and summarize the available literature on fallopian tube carcinomas.
Biopsy, Needle↗
Management and prognosis of primary fallopian tube carcinoma. Austrian Cooperative Study Group for Fallopian Tube Carcinoma.
We retrospectively analyzed 143 women treated in 28 departments from 1980 to 1995, to study the impact of prognostic factors in primary carcinoma of the fallopian tube. Further aims of the study were to evaluate the treatment of fallopian tube carcinoma in Austria. Staging of disease was done according to the modified FIGO system, and grading according to the criteria suggested by Hu et al. The mean age of the patients was 62.5 years. Sixty (42%) tumors were found to be in stage I, 28 (19%) in stage II, 38 (27%) in stage III, and 17 (12%) in stage IV. Radical resection was achieved in 102 (71%) patients. In 122 (85%) women surgery involved removal of the uterus, the adnexa, and/or the omentum or lymph nodes. Postoperatively patients underwent adjuvant therapy consisting of either irradiation (n = 40; 28%) or chemotherapy (n = 70; 49%); 33 women (23%) did not receive any treatment after surgery. The 5-year survival rate for all stages of disease was 43%. The 5-year survival rate was 59% for stages I and II and 19% for stages III and IV. FIGO stage, histologic grading and residual tumor showed an independent prognostic impact in multivariate analysis.
Adult↗
Contractile effect of acetylcholine on isolated ampullar segment of Fallopian tubes.
The Fallopian tubes are scarcely innervated with cholinergic nerve fibers. Acetylcholine released from these nerves contracts smooth muscles of the tubes. The aim of our study was to investigate the effect of acetylcholine on the Fallopian tubes using selective antagonists in different hormonal settings. We have investigated effects of acetylcholine on isolated ampulla of Fallopian tubes taken from 83 patients during abdominal hysterectomy with adnexectomy. Twenty-eight patients were in follicular, 36 were in luteal phase of menstrual cycle, and 19 patients were in menopause. Selective and non-selective muscarinic and nicotinic receptor blockers were used for investigation of the effects. Acetylcholine (from 1.8 to 658.6 microM/l) produced concentration-dependent tonic contraction of ampulla taken from the patients in follicular phase, luteal phase and menopause. The nicotinic receptor blocker mecamylamine (6.5 microM/l) and local anesthetic lidocaine (230.8 microM/l) did not affect the effect of acetylcholine. While M(1)- and M(2)-selective muscarinic receptor blockers pirenzepine (1.6 microM/l) and methoctramine (0.9 microM/l) did not show specific effect, atropine (0.01 microM/l) and selective M(3)-receptor blocker p-fluoro-hexahydro-sila-difenidol (pFHHSiD, 0.2 microM/l) effectively blocked contractions caused by acetylcholine (maximal pA(2) values 9.74 and 7.54, respectively). The affinity of pFHHSiD for muscarinic receptors was highest in the follicular phase. The results of our study suggest existence of functional M(3) muscarinic receptors in ampulla of Fallopian tubes, located on the smooth muscle cells.
Acetylcholine↗
Contractile effect of acetylcholine on isolated isthmic segment of fallopian tubes.
The Fallopian tubes are sparsely innervated with cholinergic nerve fibers. Acetylcholine is released from these nerves and contracts the smooth muscles of the tubes. The aim of our study was to investigate the effect of acetylcholine on the isthmic segment of the Fallopian tubes using selective antagonists in different hormonal settings. We investigated the effects of acetylcholine on the isolated isthmus of Fallopian tubes taken from 83 patients during abdominal hysterectomy with adnexectomy. Twenty-eight patients were in the follicular phase, 36 were in the luteal phase of the menstrual cycle, and 19 patients were in menopause. Selective and non-selective muscarinic and nicotinic receptor antagonists were used. Acetylcholine (1.8-658.6 micro M) produced concentration-dependent tonic contraction of isthmus taken from the patients in the follicular phase, the luteal phase and menopause. The nicotinic receptor antagonist mecamylamine (6.5 micro M) and local anesthetic lidocaine (230.8 micro M) did not alter the effect of acetylcholine. While M(1) and M(2)-selective muscarinic receptor antagonists pirenzepine (1.6 micro M) and methoctramine (0.9 micro M) did not show specific effect, atropine (0.01 micro M) and the selective M(3)-receptor antagonist p-fluoro-hexahydro-sila-difenidol (pFHHSiD; 0.2 micro M) effectively blocked contractions caused by acetylcholine (maximal pA(2) values 9.74 and 7.54, respectively). The affinity of pFHHSiD for muscarinic receptors was highest in the follicular phase. The results of our study suggest the existence of functional M(3) muscarinic receptors in the isthmus of the Fallopian tubes, located on the smooth muscle cells.
Acetylcholine↗
Involvement of a nitric oxide-cyclic guanosine monophosphate pathway in control of fallopian tube contractility.
Fallopian tube smooth muscle contractions are physiologically related to transport of the ovum within the oviduct. Nitric oxide (NO) has proved to be a mediator of tubal contractility. The main pathway by which NO exerts its relaxing effect on tubal contractions has not been fully elucidated. NO-mediated effects may be cyclic guanosine monophosphate (cGMP)-dependent or cGMP-independent. The objective of the present study was to investigate whether a NO-cGMP pathway is present in the Fallopian tube and, if present, to examine whether this pathway is involved in tubal contractility. Tubal smooth muscle strips were mounted in organ baths for measurement of tissue cGMP and for isometric recording of contractile activity. Following administration of the NO donor spermine NONOate a more than three-fold increase in tissue levels of cGMP was measured. Pretreatment with inhibitors of cGMP production prior to administration of spermine NONOate resulted in similar levels of cGMP as found in strips exposed to only plain buffer solution. Administration of spermine NONOate to muscle baths resulted in a significant inhibition of contractile activity, while pretreatment with inhibitors of cGMP production almost eliminated the relaxing effect of the NO donor. This study showed that a NO-cGMP pathway is present in the Fallopian tube and that the pathway is involved in Fallopian tube contractility.
Adult↗
A 15-year overview of management and prognosis in primary fallopian tube carcinoma. Austrian Cooperative Study Group for Fallopian Tube Carcinoma.
143 women treated in 28 departments from 1980 to 1995 were retrospectively analysed to study the impact of prognostic factors in primary carcinoma of the fallopian tube. The mean age of the patients was 62.5 years. Sixty (42%) tumours were FIGO stage I, 28 (20%) stage II, 38 (27%) stage III, 17 (12%) stage IV. Complete radical resection was achieved in 102 (71%) patients. In 122 (85%) women, surgery involved removal of the uterus, the adnexa, and/or the omentum or lymph nodes. Postoperative therapy consisted of either irradiation (n = 40; 28%) or chemotherapy (n = 70; 49%); 33 women (23%) did not receive any treatment after surgery. The 5-year survival rate for all cases was 43%. The 5-year survival rate was 59% for stages I and II and 19% for stages III and IV (P < 0.00001). FIGO stage, histological grade and presence of residual tumour had an independent prognostic impact in multivariate analysis. In order to investigate the role of p53 in primary fallopian tube carcinomas, we analysed the immunohistochemical expression of p53 protein regarding survival and FIGO stage in 63 patients (44%). No statistical significance was observed.
Adult↗
Prognostic factors in primary fallopian tube carcinoma. Austrian Cooperative Study Group for Fallopian Tube Carcinoma.
A retrospective nationwide evaluation of primary fallopian tube carcinomas for a period of 10 years (1980-1990) was performed to evaluate the prognostic impact of various factors. Sixty-six cases were investigated for the prognostic influence of estrogen (ER) and progesterone (PgR) status, mitotic activity, degree of nuclear anaplasia, and inflammatory reaction. ER and PgR receptors were detected by immunohistochemistry from paraffin sections. Forty-two percent were PgR-positive and 26% were ER-positive. However, no correlation of steroid receptors with survival could be found. Ninety-two percent of all tumors showed a moderate and high degree of nuclear anaplasia and only 8% showed a low degree of nuclear anaplasia. Thirty-four (52%) samples from all patients revealed low mitotic activity compared to 32 (48%) with an intermediate and high mitotic rate. Twenty-four (37%) tissue samples showed a positive inflammatory reaction which correlated with a significantly better outcome compared with tumors without this feature. This finding was also confirmed in multivariate analysis as an independent prognostic factor.
Fallopian Tube Neoplasms↗
Progesterone inhibits insulin-like growth factor binding protein-1 (IGFBP-1) production by explants of the Fallopian tube.
The Fallopian tube provides the environment for early embryo growth, a process which is influenced by insulin-like growth factors (IGFs) in the tubal fluid. Whether the bioavailability of tubal IGFs is modulated by locally produced IGF-binding protein (IGFBP-1) is not clear. An explant culture system from human Fallopian tube mucosa was, therefore, developed enabling the potential for IGFBP-1 production by this tissue to be examined directly. Initial characterization of the system established that the explants maintained responsiveness to steroids. Thus, oviduct-specific glycoprotein production, a major product of the oviduct in vivo, continued to be made via an estrogen-sensitive pathway in the culture. The presence of mRNA for IGFBP-1 was established within the explants by the use of quantitative RT-PCR and IGFBP-1 protein was measured by enzyme-linked immunosorbent assay. Although insulin and estradiol had no consistent effect on IGFBP-1, addition of progesterone had a significant inhibitory effect on IGFBP-1 production, both at the mRNA and protein levels. A dose-range of progesterone revealed an incremental inhibitory effect of progesterone on IGFBP-1 output (maximal effect, 25-50 nmol/l), consistent with physiological inhibition of this process during the luteal phase. We suggest that progesterone might, therefore, play a role in controlling the bioavailability of IGFs to the embryo during early development within the Fallopian tube.
Adult↗
Physiologic significance of 17beta-estradiol binding in the rabbit Fallopian tube.
Rabbit Fallopian tube contractility was recorded in vitro during perfusion with either Locke's solution or that solution containing CN-55, 945-27 (CN; or CI-628), a nonsteroidal estrogen antagonist (Endocrinology 79: 153, 1966). Contractility was inhibited and 17beta-estradiol (E2) displaced from both its cytoplasmic (8S) and nuclear (4S) receptors in the presence of the above agent. These effects result from a direct interaction between CN and the E2-receptor complexes. Two types of evidence show the specificity of the foregoing responses: (1) nonspecific binding of E2 to serum proteins was unaffected by the antagonist and (2) CN had no effect on contractility of a nontarget tissue, i.e., rabbit ileum. In addition, Fallopian tube contractions induced by strong electrical stimulation of K-depolarized tissues (i.e., in the absence of normal ionic gradients) were inhibited by CN and a decrease in the binding capacities of 8S and 4S receptors was again observed. Thus, antagonism of specific E2 binding inhibits the contractile mechanism at a level other than the cell membrane. These observations, and additional findings concerning the reversibility of CN action, indicate that E2 binding is essential for contractility of the rabbit Fallopian tube.
Animals↗
Sonographic appearance of fallopian tube carcinoma.
Fallopian tube carcinoma is the least common of gynecological malignancies. We report the case of a 56-year-old woman who presented with a 2 1/2-year history of intermittent vaginal bleeding and lower abdominal pain. Transvaginal sonography revealed a cystic lesion of the fallopian tube with papillary projections, distinct from the ovary and uterus. Doppler examination showed low vascular impedance (resistance index 0.50, pulsatility index 0.80). The suspicion of tubal malignancy was confirmed at surgery.
Adenocarcinoma, Papillary↗
What is the true incidence of primary fallopian tube carcinoma?
Fallopian tube carcinoma can be histologically indistinguishable from and has a similar clinical behavior to epithelial ovarian carcinoma. However, it is considerably less common; only approximately 1000 cases have been recorded in the literature. In the prevalence screen of 22000 women participating in The Royal London Hospital, London, UK, ovarian cancer screening project, three cases of early stage primary fallopian tube carcinoma were diagnosed following the finding of an elevated serum level of the CA 125 antigen. The ratio of epithelial ovarian : tubal cancer developing in these postmenopausal volunteers was 6:1. This is 25-fold greater than the expected ratio. It is difficult to attribute this finding to population selection bias. However, it is possible that the screening test was particularly effective in detecting tubal carcinoma or that, in clinical practice, the true primary site of origin of some tumors classified as widely disseminated ovarian cancer is in the fallopian tube.
Journal Article↗