title: Incidental Serous Tubal Intraepithelial Carcinoma and Non-Neoplastic Conditions of the Fallopian Tubes in Grossly Normal Adnexa: A Clinicopathologic Study of 388 Completely Embedded Cases.
abstract: Serous tubal intraepithelial carcinoma (STIC), the putative precursor of the majority of extrauterine high-grade serous carcinomas, has been reported in both high-risk women (those with a germline BRCA mutation, a personal history of breast carcinoma, and/or family history of breast or ovarian carcinoma) and average risk women from the general population. We reviewed grossly normal adnexal specimens from 388 consecutive, unselected women undergoing surgery, including those with germline BRCA mutation (37 patients), personal history of breast cancer or family history of breast/ovarian cancer (74 patients), endometrial cancer (175 patients), and a variety of other conditions (102 patients). Among 111 high-risk cases and 277 non-high-risk cases, 3 STICs were identified (0.8%), all in non-high-risk women (high risk vs. non-high risk: P=not significant). STIC was found in 2 women with nonserous endometrial carcinoma and 1 with complex atypical endometrial hyperplasia. Salpingoliths (mucosal calcifications), found in 9% of high-risk cases, and fimbrial adenofibromas in 9.9% of high-risk cases, were significantly more common in high-risk as compared with non-high-risk women (1.8% and 2.5%, respectively; P<0.007). Mucinous metaplasia was found in 3.1%, salpingitis isthmica nodosa in 3.4%, hemosiderin or pseudoxanthoma cells in 4.9%, and fibrous luminal nodules in 4.1%. None of these latter features differed significantly in the high-risk versus non-high-risk groups. These findings suggest a possible association between STIC and endometrial hyperplasia and carcinoma, and clarify the frequency of non-neoplastic tubal findings in grossly normal fallopian tubes.
authors.affiliation: Molecular Pathology and Cytology Branch (J.D.S.), Center for Devices and Radiological Health, Division of Molecular Genetics and Pathology, Office of In Vitro Diagnostics and Radiological Health, Food and Drug Administration, Silver Spring Department of Pathology Obstetrics and Gynecology (R.V.), Johns Hopkins Medical Institutions, Baltimore, Maryland Department of Pathology (J.K.), Washington Hospital Center, Washington, District of Columbia Department of Pathology (A.Y.), MD Anderson Cancer Center, Austin, Texas.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Seidman
authors.forename: Jayashree
authors.initials: J
authors.lastname: Krishnan
authors.forename: Anna
authors.initials: A
authors.lastname: Yemelyanova
authors.forename: Russell
authors.initials: R
authors.lastname: Vang
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000473:pathology; D005184:Fallopian Tube Diseases / Q000175:diagnosis* / Q000473:pathology; D005185:Fallopian Tube Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D005187:Fallopian Tubes / Q000473:pathology*; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008679:Metaplasia / Q000175:diagnosis / Q000473:pathology; D008875:Middle Aged; D009154:Mutation; D010051:Ovarian Neoplasms / Q000473:pathology; D011446:Prospective Studies