Contact Us

2637 E Atlantic Blvd #43110
Pompano Beach, FL 33062
Tel. +15184073707
Fax: +1-877-881-2035

Conference List

Cancers Review

March 2015, Volume 2, 1, pp 1-10

Spectrum of Morphological Changes and Prevalence of “P53 Signatures” In Tubal Fimbrial Epithelium in General Population and In Patients with Pelvic Serous Carcinomas

Gayatri Ravikumar


Julian Crasta

Gayatri Ravikumar 1 ,

Julian Crasta 1 
  1. Department of Pathology, St.John’s Medical College, Bangalore, Koramangala, Sarjapur Road, Bangalore, India 1

Pages: 1-10

DOI: 10.18488/journal.95/2015.2.1/

Share :


Aim: Pelvic serous carcinomas (PSCs) are very aggressive malignancies and   present at advanced stage. A paradigm shift in the origin and pathogenesis of PSCs occurred when precursor lesions were found in the Fallopian tube fimbria in the prophylactic bilateral salphingo-ophorectomy (PBSO) specimens from BRCA positive patients. The knowledge of various benign and reactive alterations in the Fallopian tube is mandatory to distinguish these lesions from the true neoplastic changes. The study therefore aims to see the spectrum of morphological changes in the Fallopian tube epithelium (FTE) and to know the incidence of the various precursor lesions and p53 signatures in the tubal fimbria. Method: The study included 102 Fallopian tubes from patients undergoing salphingo – oophorectomies for gynaecological indications. The fimbrial end along with one cross section was embedded and examined for stromal and architectural changes, epithelial features and inflammatory infiltrates.  IHC for p53 and Ki67 was done to assess the presence of precursor lesions. Results: The mean age of patients’ was 49.9yrs. Family history of breast/ovarian cancer was present in 5 cases. Histopathology showed fibrosis (30%), Walthard nest (36%) , Wolfian duct remnants(14.7%), pigmentosis tubae(1%) , infiltration by metastatic carcinoma(7%),reactive atypia(6%), metaplasia(16%), tufting(46%),lymphocytes (9%) and plasma cells (2%). SCOUTS were seen in 12%, p53 signature and STIC in 6% and 4% respectively. Tuboperitoneal junction was identified in 15 cases and showed transitional metaplasia. Conclusion: The study describes the different morphological changes in the Fallopian tube in our population. The prevalence of cytological and molecular alterations leading to malignancy was low in general population. 

Contribution/ Originality
The paper’s primary contribution is finding that completely sampling the tubal fimbria with one cross section is a good practice to identify early precursor lesions which may otherwise go undetected. Knowledge of reactive /benign cellular proliferations is mandatory to help distinguish them from these precursor lesions.




  1. M. Mehrad, G. Ning, E. Y. Chen, K. Mehra, and C. Crum, "A pathologist’s road map to Benign, precancerous, and malignant intraepithelial proliferations in the fallopian tube," Adv. Anat. Pathol., vol. 17, pp. 293–302, 2010.
  2. T. Herzog and H. Dinkelspiel, "Fallopian tube removal: Stic-ing it to ovarian cancer: What is the utility of prophylactic tubal removal," Curr. Oncol., vol. 20, pp. 148-151, 2013.
  3. C. Crum, R. Drapkin, D. Kindelberger, F. Medeiros, A. Miron, and Y. Lee, "Lessons from BRCA: The tubal fimbria emerges as an origin for pelvic serous cancer," Clin. Med. Res., vol. 5, pp. 35-44, 2007.
  4. C. Crum, "Intercepting pelvic cancer in the distal fallopian tube: Theories and realities," Mol. Oncol., vol. 3, pp. 165-170, 2009.
  5. Y. Lee, A. Miron, R. Drapkin, M. Nucci, F. Medeiros, A. Saleemuddin, J. Garber, C. Birch, H. Mou, and R. Gordon, "A candidate precursor to serous carcinoma that originates in the distal fallopian tube," J. Pathol., vol. 211, pp. 26-35, 2007.
  6. E. Chen, K. Mehra, M. Mehrad, G. Ning, A. Miron, G. Mutter, N. Monte, B. Quade, F. McKeon, and Y. Yassin, "Secretory cell outgrowth, PAX2 and serous carcinogenesis in the fallopian tube," J. Pathol., vol. 222, pp. 110-116, 2010.
  7. J. Rabban, K. Garg, B. Crawford, L. Chen, and C. Zaloudek, "Early detection of high-grade tubal serous carcinoma in women at low risk for hereditary breast and ovarian cancer syndrome by systematic examination of fallopian tubes incidentally removed during benign surgery," Am. J. Surg. Pathol., vol. 38, pp. 729–742, 2014.
  8. J. Seidman, A. Yemelyanova, R. Zaino, and R. Kurman, "The fallopian tube-peritoneal junction: A potential site of carcinogenesis," Int. J. Gynecol. Pathol., vol. 30, pp. 4–11, 2011.
  9. J. Rabban, B. Crawford, L. Chen, C. Powell, and C. Zaloudek, "Transitional cell metaplasia of fallopian tube fimbriae. A potential mimic of early tubal carcinoma in risk reduction salpingo-oophorectomies from women with BRCA mutations," Am J Surg Pathol., vol. 33, pp. 111–119, 2009.
  10. A. Folkins, E. Jarboe, A. Saleemuddin, Y. Lee, M. Callahan, and R. Drapkin, "A candidate precursor to pelvic serous cancer (p53 Signature) and its prevalence in ovaries and fallopian tubes from women with heterozygous BRCA mutations," Gynecol. Oncol., vol. 109, pp. 168–173, 2008.
  11. Finch, "Salpingo-oophorectomy and the risk of ovarian, fallopian tube, and peritoneal cancers in women with a BRCA1 or BRCA2 mutation," JAMA, vol. 296, pp. 185–192 2006.
  12. M. Callahan, C. Crum, and F. Medeiros, "Primary fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction," J. Clin. Oncol., vol. 25, pp. 3985–3990, 2007.
  13. F. Medeiros, M. Muto, and Y. Lee, "The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome," Am. J. Surg. Pathol., vol. 30, pp. 230–236, 2006.
  14. R. Vang, K. Visvanathan, A. Gross, E. Maambo, and M. Gupta, "Validation of an algorithm for the diagnosis of serous tubal intraepithelial carcinoma," Int. J. Gynecol. Pathol., vol. 31, pp. 243–253, 2012.
  15. A. Yemelyanova, R. Vang, M. Kshirsagar, D. Lu, M. Marks, I.-M. Shih, and R. Kurman, "Immunohistochemical staining patterns of p53 can serve as a surrogate marker forTP53 mutation in ovarian carcinoma: An immunohistochemical and nucleotide sequencing analysis," Mod. Pathol., vol. 24, pp. 1248–1253, 2011.
  16. S. Lauchlan, "The secondary mullerian system," Obstet. Gynecol. Surv., vol. 27, pp. 133-146, 1972.
  17. R. Kurman and I.-M. Shih, "The origin and pathogenesis of epithelial ovarian cancer: A proposed unifying theory," Am. J. Surg. Pathol., vol. 34, pp. 433–443, 2010.
  18. Przybycin, R. Kurman, B. Ronnett, M. Shih Ie, and R. Vang, "Are all pelvic (Nonuterine) serous carcinomas of tubal origin," Am. J. Surg. Pathol., vol. 34, pp. 1407-1416, 2010.
  19. J. Hunt and A. Lynn, "Histologic features of surgically removed fallopian tubes," Arch. Pathol. Lab. Med., vol. 126, pp. 951–955, 2002.


Google Scholor ideas Microsoft Academic Search bing Google Scholor


Competing Interests:


Related Article

( 1 ) Spectrum of Morphological Changes and Prevalence of “P53 Signatures” In Tubal Fimbrial Epithelium in General Population and In Patients with Pelvic Serous Carcinomas
( 3 ) Acute Renal Failure, Electrolyte and Acid-Base Changes in Three Cases with Ileostomy
( 5 ) The Potential Protective Role of Chamomile Extract on Rat Liver Ultrastructural Changes Induced by 2, 4-Dichlorophenoxyacetic Acid
( 6 ) Prevalence and Infection Patterns of Geo-Helminthiasis in a Rural Community along River Okumeshi, Delta State, Nigeria: A Cross-Sectional Study
( 7 ) Prevalence and Factors Associated With Refractive Error among Primary School Children in Addis Ababa, Ethiopia
( 8 ) Prevalence of Stunting and Associated Factors among Under Five Children in Wondo Genet Woreda, Sidama Zone, Southern Ethiopia
( 10 ) Seroprevalence of Herpes Simplex Virus Type 2 (HSV-2) Infection Among HIV Patients Accessing Healthcare at Federal Medical Centre, Keffi, Nigeria
( 11 ) Prevalence of Prehypertension and Assessment of Renal Function among the Prehypertensive Students of the College of Health Sciences, Nnamdi Azikiwe University, Nnewi, Anambra State, Nigeria
( 12 ) Major Depression with Delusional Prevalence and Fixation in Neurotransmitters
( 13 ) Prevalence of Prediabetes and the Associated Risk of Kidney Disease in Apparently Healthy Subjects in Nnewi, Anambra State, Nigeria
( 14 ) A Retrospective Assessment of Syphilis Seroprevalence among Pregnant Women, Cape Coast, Ghana
( 21 ) How Do Patients Evaluate the New Health Care System in General Practice? Results from the European Project on Patient Evaluation of General Practice Care (Europep) in Adana, Turkey
( 22 ) Xerostomia in Geriatric Population: An Insight into Etiopathogenesis, Diagnosis and Management
( 24 ) A Sample Survey on Reproductive Women to Assess Level of Stress in Sub-Urban Population, South Chennai, India
( 25 ) Mortalities Profile among Dubai Population 2017, Utilizing Breakdown Fractions for Intervention and Forecasting of Future Epidemiologic Transition - Dubai, UAE 2019
( 26 ) Ultrasound Guided Axillary Node Sampling in Patients of Carcinoma Breast with Clinically Negative Axilla: A Pilot Study
( 27 ) Prognostic Factors in Patients with Squamous Cell Carcinoma of the Oral Tongue Treated With Adjuvant Therapy Following Surgery
( 28 ) Update on Nutritional Aspects of Gluten-Free Diet in Celiac Patients
( 29 ) Role of Iron Metabolism in Breast Cancer Patients
( 30 ) Prosthodontic Rehabilitatative Therapy through Surgical Obturator for Maxillectomy Patients: A Review
( 31 ) Correlation between Her2/Neu and Histopatholoical Finding among Sudanese Female Breast Cancer Patients
( 32 ) Impaired Immune Phenotype of Circulating Endothelial-Derived Microparticles in None-Diabetic Patients with Chronic Heart Failure: Impact on Insulin Resistance
( 33 ) Evaluation of Techniques for the Diagnosis of Rotavirus Gastroenteritis in Paediatric Patients
( 35 ) The Importance of Clinical Genotype in Patients with Klinefelter Syndrome. A Genetic Disorder Asociated to Taurodontism
( 36 ) Correlation between Certain Complications and Health Education Program among Non-Insulin Dependent Diabetes Miletus Patients
( 37 ) Epidemiological and Clinical Characteristics of Egyptian Patients with Hepatocellular Carcinoma: A Single Center Study
( 38 ) Study of Hepatic Dysfunction in Patientsinfected with Dengue Virus
( 40 ) Profile of Patients Visiting a Tertiary Eye Hospital and their Perception Regarding Barrier for Eye Care Services in the Western Saudi Arabia
( 42 ) Development of Periodontitis after Antihelicobacter Therapy in Patients with Ulcer Disease
( 43 ) Reducing Surgical Site Infection by Placing Subcutaneous Drain in the Obese Patients
( 44 ) Domiciliary Care Providers Views on Provision of Palliative Care for their Cancer Patients
( 45 ) Hawaii Dementia Prevention Trial: A Randomized Trial Evaluating a Multifaceted Nutritional Intervention to Slow Cognitive Decline in Mild Cognitive Impairment Patients
( 46 ) Self-Esteem, Optimism and Burden of Care among Relatives of Cardiovascular Disease Patients in Selected Tertiary Hospitals in Southwest, Nigeria
( 50 ) Non Syndromic, Bilateral, Dentigerous Cysts Associated with Inverted Mandibular Third Molars: A Case Report
( 51 ) Effect of Different Chronotype on Comorbidity and Resistance to Psycho-Emotional Stress in Hypertension Associated With Hepato-Biliary Pathology in the North
( 52 ) Effect of Dietary Supplementation with Cyphostemma Digitatum on Serum Lipid Profile and Liver Enzymes in Hyperlipidemic Subjects
( 53 ) Effectiveness of Treatment of Water Surface with Ferric Chloride and Aluminium Sulphate