title: Transtubal spread of endometrial carcinoma: correlation of intra-luminal tumour cells with tumour grade, peritoneal fluid cytology, and extra-uterine metastasis.
abstract: To assess the significance of intra-luminal tumour cells (ILTC) within the fallopian tubes of patients with endometrial carcinoma, with emphasis on high grade histological subtypes.
  
  
  
  Complete histological examination of fallopian tube tissue was performed in 36 low grade endometrioid adenocarcinomas and in a consecutive series of 226 high grade endometrial malignancies including 92 serous carcinomas, 64 grade 3 endometrioid carcinomas, 26 carcinosarcomas, 25 undifferentiated/dedifferentiated carcinomas, and 19 clear cell carcinomas. The presence of ILTC was correlated with peritoneal fluid cytology, histologically confirmed peritoneal tumour spread, and lymph node metastases.
  
  
  
  ILTC were identified in 26% and 3% of high and low grade carcinomas, respectively. The presence of ILTC correlated strongly with positive peritoneal fluid cytology and with peritoneal metastasis in high grade tumours (both p < 0.001), and there was also a correlation with lymph node metastasis (p = 0.049). ILTC were more common in serous and undifferentiated carcinomas (>30%) but the differences between the high grade tumour subtypes were not statistically significant.
  
  
  
  These findings suggest that ILTC associated with high grade endometrial cancers have the capacity to implant and invade the peritoneal cavity. Positive cytology in such cases may be more significant than in low grade tumours. Complete tubal examination may provide additional prognostic information in high grade endometrial carcinoma.
authors: Department of Histopathology, King Edward Memorial Hospital, Perth, WA, Australia. colin.stewart@health.wa.gov.au
authors: C J R
authors: CJ
authors: Stewart
authors: D A
authors: DA
authors: Doherty
authors: M
authors: M
authors: Havlat
authors: M H E
authors: MH
authors: Koay
authors: Y C
authors: YC
authors: Leung
authors: A
authors: A
authors: Naran
authors: D
authors: D
authors: O'Brien
authors: S
authors: S
authors: Ruba
authors: S
authors: S
authors: Salfinger
authors: J
authors: J
authors: Tan
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary*; D018262:Adenocarcinoma, Clear Cell / Q000556:secondary; D001202:Ascitic Fluid / Q000473:pathology*; D018269:Carcinoma, Endometrioid / Q000556:secondary; D002296:Carcinosarcoma / Q000556:secondary*; D018284:Cystadenocarcinoma, Serous / Q000556:secondary; D016889:Endometrial Neoplasms / Q000473:pathology*; D005187:Fallopian Tubes / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D010534:Peritoneal Neoplasms / Q000556:secondary; D011446:Prospective Studies