Hyaline globule-like structures in undifferentiated sarcoma cells of malignant müllerian mixed tumor of the fallopian tube.

Malignant müllerian mixed tumors (MMMTs) of the fallopian tube are very rare neoplasms, and we present such a case with unusual findings here. A 57-year-old Japanese woman, after she received a medical checkup, underwent salpingo-oophorectomy on the suspicion of ovarian cancer. At the time of operation, the main tumor was present predominantly in the fallopian tube. Microscopically, the tumor consisted of carcinoma and sarcoma components. The carcinoma showed moderately to poorly differentiated adenocarcinoma. The sarcoma consisted of predominantly undifferentiated sarcoma and focally rhabdomyosarcomatous cells with abundant eosinophilic cytoplasm. Immunohistochemically, the differentiation toward rhabdomyosarcoma was confirmed. Interestingly, the cytoplasm of undifferentiated sarcoma cells contained hyaline globule-like structures. These structures showed a positive reaction for PAS, and these structures were not digested by the diastase pretreatment. Ultrastructurally, hyaline globule-like structures corresponded to lysosomes. Finally, pathologists should keep in mind that undifferentiated sarcoma cells in MMMT of the fallopian tube may contain hyaline globule-like structures in the cytoplasm.

Hepatoid carcinoma with serous component of the fallopian tube: a case report with immunohistochemical and ultrastructural studies.

A very rare case of hepatoid carcinoma with serous component arising in the fallopian tube of a 79-year-old woman is presented. The lesion was a 5.0-cm unencapsulated, yellowish-white soft mass. The tumor was composed of hepatoid carcinoma (90%) and serous carcinoma (10%) components. The hepatoid carcinoma was histologically characterized by a proliferation of round to polygonal cells arranged in a trabecular, tubular, sinusoidal, papillary, or solid pattern. The serous component in the fallopian tube also showed in situ lesions. Both components showed an infiltration into the surface of the left ovary, omentum, peritoneum including the pouch of the Douglas, and serosa of the colon. Immunohistochemically, the hepatoid carcinoma was positive for alpha-fetoprotein, polyclonal carcinoembryonic antigen (CEA), hepatocyte paraffin 1, albumin, epithelial membrane antigen, and cytokeratin (CAM5.2). Ultrastructurally, the cytoplasm contained abundant ribosomes, moderate amounts of mitochondria, and rough endoplasmic reticulum that developed into a meshwork and contained mitochondria within it. Microbile channel-like structures and desmosomes were occasionally observed. The association with serous carcinoma indicates mullerian origin rather than germ cell origin. The patient received chemotherapy and was alive without disease at 10 months after surgery.

Prognostic impact of DNA content and AUER classification in primary fallopian tube carcinoma.

DNA ploidy has been studied in 61 primary fallopian tube carcinomas using image-cytometry. The investigation also included survival analysis, and ploidy classification according to AUER was performed in order to evaluate its prognostic impact for fallopian tube carcinoma. A high number of aneuploid cases were observed (79% aneuploid vs. 21% euploid tumors). The high incidence of aneuploid tumors was consistently observed among all FIGO-stages as well as all groups of histologic grading. There was no correlation between ploidy and FIGO-stage or histologic grading. Patients with euploid DNA content showed a median survival of 34 months compared to 24 months for aneuploid cases (log-rank, P = 0.83). No correlation between the AUER classification and FIGO-stage or histologic grading could be observed. Tumors with an AUER type I and II (75th quantile 41 months) showed a better outcome than tumors with AUER III and IV (75th quantile 19 months). Although these results did not reach statistical significance (P = 0.07), a trend could be observed. Therefore AUER classification may be useful as an objective prognostic parameter. The high incidence of aneuploid tumors could be an expression of the high biologic aggressiveness of primary fallopian tube cancer which has been repeatedly mentioned in the past.

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.

Transitional cell carcinoma of the fallopian tube: a light and electron microscopic study.

Carcinomas other than adenocarcinomas are extremely rare in the fallopian tube. We report a case of a malignant neoplasm of the fallopian tube with histological features of transitional cell carcinoma that presumably arose from an extraluminal region of the tube. A 57-year-old postmenopausal woman with vaginal bleeding was found to have a left adnexal tumor. Exploratory laparotomy revealed a left tubal tumor with a metastatic nodule on the rectal surface. Histologically, the tumor surrounded the lumen of the left fallopian tube and was composed of cells with "coffee-bean"-like nuclei arranged in solid nests without keratinization. No abnormalities were found in the right tube, ovaries, or uterus. Electron microscopy revealed the tumor cells to have nuclei with deep nuclear indentations, cytoplasmic tonofilaments, and intercellular spaces with prominent interdigitations of the cell membrane. In addition, several tumor cells with protruding microvilli formed abortive lumina. These histological and ultrastructural features were consistent with the diagnosis of transitional cell carcinoma.

Metaplastic papillary tumor of the fallopian tube. Case report, immunohistochemical features, and review of the literature.

An example of a unique oncocytic and mucinous lesion of the fallopian tube epithelium, found incidentally in the postpartum period, is presented. The histogenetic nature of this lesion and its ultrastructural and immunohistochemical features are discussed.

Metaplastic papillary tumor of the fallopian tube: a case report with ultrastructure.

This is the fifth metaplastic papillary tumor of the fallopian tube identified in a postpartum tubal ligation. Light microscopic studies demonstrate a mucinous metaplasia. The ultrastructure of this unusual papillary epithelial proliferation reveals abundant filaments with condensations. The tumor has not recurred during 4 years of follow-up.

Adenosquamous carcinoma of the fallopian tube. A clinicopathologic case report with verification of the diagnosis by immunohistochemical and ultrastructural studies.

A middle-aged woman presented with a pelvic mass. Pathologic examination of the resected specimen revealed a primary adenosquamous carcinoma of the left fallopian tube. Special studies supported the concept of the neoplastic cells differentiating along two major pathways, squamous cell carcinoma and mucin-producing adenocarcinoma.

Adenomatoid tumours: an immunohistochemical and ultrastructural appraisal of their histogenesis.

The histogenesis of adenomatoid tumour has continued to provoke debate since Golden and Ash suggested the term in 1945 for a characteristic benign neoplasm typically found in the uterus, fallopian tube or epididymis. Endothelial, epithelial, mesonephric, müllerian and mesothelial histogenesis have been suggested. The balance of evidence suggests mesothelial derivation, but two recent studies point to endothelial origin for at least some of these tumours. Twenty-two histologically typical adenomatoid tumours were studied by electron microscopy, mucin histochemistry and immunohistochemistry. Ultrastructurally, all cases showed vacuolated cells bearing long bushy microvilli and the features were not those of endothelial cells. Glandular spaces contained acid mucopolysaccharide consistent with hyaluronic acid. Immunohistochemical double labelling techniques showed the cells lining such spaces to contain cytokeratin in the absence of factor VIII related antigen and receptors for Ulex europaeus I lectin which were expressed in the endothelium of tumour blood vessels. The evidence points to mesothelial histogenesis in all cases examined.

Choriocarcinoma of the mesosalpinx masquerading as congestive heart failure: ultrastructural observations of the tumor.

A 45-year-old woman suffered from hypertension and congestive heart failure for 5 months. She was found to have a choriocarcinoma of the left mesosalpinx. The final event was, in all probability, a massive pulmonary tumor embolus which occurred shortly after removal of the uterus and adnexae. The tumor was studied by immunohistochemical methods as well as ultrastructurally, and the findings are illustrated and described.

Adenocarcinoma of the Fallopian tube. An ultrastructural study.

A case of fallopian tube adenocarcinoma was studied by light and transmission electron microscopy. The neoplastic cells contained abundant mitochondria, moderate to large amounts of rough endoplasmic reticulum (RER) arranged in parallel arrays and often containing amorphous material, annulate lamellae, possible secretory vesicles, and glycogen. The presence of stacked RER and annulate lamellae together is unusual in papillary serous cystadenocarcinoma of the ovary, and has not been described in Fallopian tube adenocarcinoma. Golgi complexes were are. Small acini with projecting microvilli as well as junctional complexes were present, but cilia were not found. The electron microscopic findings suggest secretory activity, and are remarkably similar to those found in papillary serous cystadenocarcinomas of the ovary. The findings also support the hypothesis that ovarian serous tumors and adenocarcinomas of the Fallopian tube are derived from coelomic epithelium.

[An ultrastructural study of primary carcinoma of the fallopian tube (author's transl)].

Primary carcinoma of the fallopian tube is one of the least common neoplasms arising from the female genital tract with rare preoperative correct diagnosis. Recently, we had chances to experience two cases of this tumor, one of which was examined electron microscopically. Both of them revealed the well-differentiated pattern of papillary adenocarcinoma. Electron microscopically, most of the cancer cells had pleomorphic nuclei, giant or multiple nucleoli, numerous mitochondria, poorly developed rER and abundant polysomes. Small number of cells rich in lysosome-like granules were also observed near the basement membrane. Among the cancer cells, "ultrastructural alveolar spaces", composed of several cancer cells, were prominent. In the cancer cells, there were observed the following interesting observations; annulate lamellae-like structure, unusual bundles of the filamentous elements and lamellar body-like structures. Normal tubal epithelium consisted of ciliated cells, secretory cells, peg cells and so-called "indifferent cells". The fact that the present tumor had no ciliated cells and few secretory cells indicated that this tumor was originated from "indifferent cells" or peg cells.

Ovarian hilus cell heterotopia.

A systematic pathologic study was done of the paratubal and parametrial tissues, submitted along with distal tubal segments excised for sterilization and with uteri (with or without attached adnexa) removed for common gynecologic conditions. Heterotopic ovarian hilus cell rests were noted in 12 cases, giving an overall incidence of 0.52% (12/2299). These cell rests, confined exclusively to the endosalpinx and perisalpinx, were easily differentiated from pregnancy-related decidual nodules, Walthard rests, foci of paratubal endometriosis, and ectopic adrenal rests.

Ultrastructure of fallopian tube carcinoma.

Fallopian tube carcinoma is one of the rarest of primary gynecologic malignancies. Normal tubal epithelium is composed of secretory, ciliated, and intercalary cells. To determine the cellular composition and ultrastructural details of this rare neoplasm, a moderately well-differentiated tubal carcinoma was studied with the electron microscope. A prominent feature was the formation of numerous ultramicro alveolar spaces lined by cell surface microvilli. The nuclei of the neoplastic cells demonstrated a variety of fine structural abnormalities. Based on cell size and shape criteria, a possible dual tumor cell population was suggested. However, no cilia were seen in any of the tumor cells and almost all were devoid of secretory granules. These latter observations suggest that this tumor was primarily a proliferation of intercalary cells.

The ultrastructure of a poorly differentiated adenocarcinoma of the human tuba uterina.

A poorly differentiated adenocarcinoma of the human oviduct was studied by light and transmission electron microscopy. Cells contained abundant mitochondria, bound and free ribosomes, prominent Golgi's bodies and aggregates of membrane-bound dense bodies. The small glandular lumina with numerous microvilli were generally devoid of cilia and contained secretory material. The neoplasm was ultrastructurally similar to poorly differentiated ovarian serous carcinomas.