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A Pathologist's Road Map to Benign, Precancerous, and Malignant Intraepithelial Proliferations in the Fallopian Tube

Mehrad, Mitra MD; Ning, Gang PhD; Chen, Eleanor Y. MD, PhD; Mehra, Karishma K. MD; Crum, Christopher Paul MD

Advances in Anatomic Pathology:
doi: 10.1097/PAP.0b013e3181ecdee1
Review Articles
Abstract

The fallopian tube has recently emerged as an important site of origin for not only early serous cancer in women with inherited mutations in BRCA1/BRCA2 but as a source of many pelvic serous carcinomas. With this increased attention has come the inevitable need to sort out what epithelial abnormalities are clinically important and how they should be reported by the practicing pathologist. This review addresses 4 categories of tubal epithelial change: (1) metaplasias; (2) nonmalignant atypias; (3) potential precursors, including secretory cell outgrowths and p53 signatures; and (4) tubal intraepithelial carcinomas. A modified protocol for sectioning the fallopian tube (SEE-FIM) is discussed and each of the above topics is covered in the context of its differential diagnosis and recommendations for reporting are included. Finally, the rationale for close inspection of the tube, both in presumed benign and malignant disease, is discussed, with reference to an ongoing multi-institutional web-based project (Pelvic-ovarian Cancer Interception project).

In Brief

All figures can be viewed online in color at http://www.anatomicpathology.com.

Author Information

Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, Boston, MA

Reprints: Christopher Paul Crum, MD, Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, Boston, MA 02115 (e-mail: ccrum@partners.org).

© 2010 Lippincott Williams & Wilkins, Inc.