Peritoneum, omentum and mesentery
Other benign lesions
Endosalpingiosis

Author: Anjelica Hodgson, M.D. (see Authors page)
Editor: Carlos Parra-Herran, M.D.

Revised: 24 October 2017, last major update October 2017

Copyright: (c) 2017, PathologyOutlines.com, Inc.

PubMed Search: Endosalpingiosis[title]

Cite this page: Hodgson, A. Endosalpingiosis. PathologyOutlines.com website. http://pathologyoutlines.com/topic/peritoneumendosalpingiosis.html. Accessed November 23rd, 2017.
Definition / general
  • Glands lined by epithelium with morphology and immunophenotype resembling fallopian tube epithelium, identified outside of the fallopian tube proper (Obstet Gynecol 1980;55:57S)
    • Ciliated and unciliated columnar cells, intercalated cells and peg cells are identified
  • Typically affects pelvic and abdominal peritoneum, usually as an incidental microscopic finding
    • Also known to involve ovary, uterus, cervix, bowel, omentum and skin
    • Rarely occurs in inguinal, mediastinal or axillary lymph nodes
  • Rarely forms a cystic mass, entitled florid cystic endosalpingiosis (Hum Pathol 2002;33:944, Am J Surg Pathol 1999;23:166)
Essential features
  • Multiple theories of origin including direct implantation of normal fallopian tube epithelium, involution of ovarian surface epithelium and metaplastic changes in multipotential peritoneal cells
  • Typically an incidental finding, except in cystic lesions which may be grossly seen
  • Seen in association with ovarian serous tumors (usually of borderline type), in conjunction with implants or alone
    • Theorized to be the precursor lesion in borderline and low grade serous neoplasms found on the peritoneum or in lymph nodes (Am J Surg Pathol 2010;34:1442)
  • May be seen in isolation but more commonly seen in conjunction with other nonneoplastic lesions of the Müllerian system, such as endometriosis and endocervicosis
Case reports
Gross description
  • Usually not grossly discernible
    • Cystic appearance when seen
Gross images

Images hosted on other servers:

Cystic endosalpingiosis

Microscopic (histologic) description
  • Glands and tubules lined by low columnar or cuboidal cells, typically with cilia
  • Psammoma bodies (J Reprod Med 2000;45:526) and papillae may be present
Microscopic (histologic) images

Images hosted on other servers:

Glandular epithelial structures

Gland with
ciliated
epithelium and
psammoma body

Comparison with metastatic breast carcinoma in axillary lymph node

PAX8+

WT1+

Cytology description
Positive stains
Negative stains
Differential diagnosis
Board review question #1
What is the expected immunohistochemical staining profile for endosalpingiosis?

  1. WT1+, PAX8+, calretinin+, BCL2-
  2. WT1+, PAX8-, calretinin+, BCL2+
  3. WT1+, PAX8+, calretinin-, BCL2+
  4. WT1-, PAX8+, calretinin-, BCL2+
  5. WT1-, PAX8-, calretinin-, BCL2-
Board review answer #1
C. WT1+, PAX8+, calretinin-, BCL2+. As endosalpingiosis is composed of tubal type epithelium and thought to be derived from the Müllerian system, it is not surprising that this lesion is positive for PAX8 and WT1. Calretinin would be expected to stain lesions of mesothelial origin and ovarian theca origin. Studies have shown that BCL2, in addition to new contemporary markers such as FOXJ1 and phospho-SMAD2, are contemporary and promising markers for tubal epithelium and endosalpingiosis (Gynecol Oncol 2014;132:316).