Brush cytology of the fallopian tube and implications in ovarian cancer screening.
OBJECTIVE
To determine whether fallopian tube epithelial cells adequate for cytopathology can be obtained via a minimally invasive approach using brush cytology.


METHODS
Prospective feasibility study (Canadian Task Force classification II-1).


METHODS
Tertiary-care university-based teaching hospital.


METHODS
Ten patients who underwent laparoscopic hysterectomy, with or without adnexal surgery, because of benign indications.


METHODS
Attempted hysteroscopic and laparoscopic brush cytologic sampling of the fallopian tubes.


RESULTS
ThinPrep slides and cell blocks were prepared and analyzed. P53 and KI-67 immunostaining was performed on cell block specimens if adequate cellularity was present. The first 5 patients underwent attempted hysteroscopic sampling of the fallopian tube, with successful collection only in 1 patient. The protocol was then modified to enable sampling of the fallopian tube laparoscopically as well as hysteroscopically. In the other 5 patients sampling of the fallopian tubes was successful laparoscopically, including successful sampling hysteroscopically in 1 patient. The brush biopsy catheter could not be passed through the entire length of the fallopian tube in either the hysteroscopic or laparoscopic approach. All cytologic findings were interpreted as benign, although findings of nuclear overlapping, crowding, and small nucleoli were initially considered benign atypia. Immunohistochemistry for P53 and KI-67 yielded uniformly negative findings.


CONCLUSIONS
To our knowledge, this is the first study to describe endoscopic brush cytology of the fallopian tubes with correlated cytologic narrative. In the future, cytologic sampling of the fallopian tube may have implications for an ovarian cancer screening test.
Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh. Electronic address: lumd@stanford.edu.
Deirdre
D
Lum
Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh.
Richard
R
Guido
Department of Pathology, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Erika
E
Rodriguez
Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh.
Ted
T
Lee
Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh.
Suketu
S
Mansuria
Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh.
Lori
L
D'Ambrosio
Department of Pathology, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
R Marshall
RM
Austin
D000328:Adult; D000368:Aged; D000818:Animals; D001706:Biopsy; D003581:Cytodiagnosis; D055088:Early Detection of Cancer; D005187:Fallopian Tubes / Q000473:pathology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007150:Immunohistochemistry; D010535:Laparoscopy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology*; D011446:Prospective Studies
Brush cytology; Fallopian tube; Hysteroscopy; Laparoscopy; Ovarian cancer prevention; Screening test