J Pathol Transl Med.  2018 Jan;52(1):21-27. 10.4132/jptm.2016.06.17.

Comparison of the Classical Method and SEE-FIM Protocol in Detecting Microscopic Lesions in Fallopian Tubes with Gynecological Lesions

• Koc N
• Ayas S
• Arinkan SA

• KMID: 2403254
• DOI: http://doi.org/10.4132/jptm.2016.06.17

Abstract

BACKGROUND
The objective of this study was to compare the classical method and Sectioning and Extensively Examining the Fimbriated End Protocol (SEE-FIM) in detecting microscopic lesions in fallopian tubes with gynecological lesions.
METHODS
From a total of 1,118 cases, 582 with various parts of both fallopian tubes sampled in three-ring-shape sections and 536 sampled with the SEE-FIM protocol were included in this study. Pathological findings of cases with endometrial carcinoma, non-uterine pelvic malignant tumor, ovarian borderline tumors, premalignancy, and benign lesions were compared.
RESULTS
We detected two tubal infiltrative carcinomas among 40 uterine endometrioid adenocarcinomas, 15 serous tubal intraepithelial carcinomas in 39 non-uterine pelvic serous high-grade carcinoma cases, seven papillary tubal hyperplasias in 13 serous borderline tumor cases, and 11 endometriotic foci and four adenomatoid tumors among all cases sampled with the SEE-FIM protocol. Using the classical method, we detected only one serous tubal intraepithelial carcinoma in 113 non-uterine pelvic serous high-grade carcinoma cases and two papillary tubal hyperplasia cases in 31 serous borderline tumors. We did not identify additional findings in 185 uterine endometrioid carcinoma cases, and neither endometriotic focus nor adenomatoid tumor was shown in other lesions by the classical method.
CONCLUSIONS
Benign, premalignant, and malignant lesions can possibly be missed using the classical method. The SEE-FIM protocol should be considered especially in cases of endometrial carcinoma, nonuterine pelvic serous cancers, or serous borderline ovarian tumors. For other lesions, at least a detailed examination of the fimbrial end should be undertaken.

Keyword

SEE-FIM method; Classical method; Fallopian tube lesions

MeSH Terms

Adenomatoid Tumor
Carcinoma in Situ
Carcinoma, Endometrioid
Endometrial Neoplasms
Fallopian Tubes*
Female
Hyperplasia
Methods*

Figure

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  Fig. 1. Polypoid infiltrative endometrioid carcinoma extending to the tubal lumen.

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  Fig. 2. Serous tubal intraepithelial carcinoma (A), positive immunostaining for p53 (B), and for Ki-67 (C).

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  Fig. 3. Papillary tubal hyperplasia. Small rounded clusters of tubal epithelial cells and small papillae associated with psammoma bodies.

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