Fallopian tubes & broad ligament

Fallopian tube nontumor

Chronic salpingitis

Editorial Board Member: Kyle Devins, M.D.
Deputy Editor-in-Chief: Gulisa Turashvili, M.D., Ph.D.
Shabnam Zarei, M.D.

Last author update: 9 February 2023
Last staff update: 9 February 2023

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PubMed Search: Chronic salpingitis

Shabnam Zarei, M.D.
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Cite this page: Zarei S. Chronic salpingitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/fallopiantubeschronicsalpingitis.html. Accessed September 27th, 2023.
Definition / general
  • Chronic inflammation of fallopian tube with lymphoplasmacytic infiltrate and with or without foamy histiocytes and granulomas
Essential features
  • Presence of plasma cells and lymphocytes in the submucosa
  • Plicae are fibrotic, fused, short and thick
  • May be associated with epithelial hyperplasia
  • Chronic salpingitis, follicular salpingitis, granulomatous salpingitis, ligneous salpingitis, pseudoxanthomatous salpingitis and xanthomatous salpingitis
ICD coding
  • ICD-10: N70.11 - chronic salpingitis
  • ICD-11: GA07.1 - chronic salpingitis and oophoritis
  • Women of reproductive age
  • Occurs in up to 50% of ectopic pregnancies
  • Fallopian tube, unilateral or bilateral
  • May be associated with active or prior history of infection (pelvic inflammatory disease) (Fertil Steril 2000;74:152)
  • May be seen in association with endometriosis or tubal ectopic pregnancy
  • Other associations include inflammatory bowel disease (with pulse granulomas) or other infectious processes (tuberculosis, sarcoidosis) (Int J Gynecol Pathol 2015;34:275)
  • Several bacterial organisms (Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma), foreign body (lubricants, mineral oil, starch), endometriosis
  • Usually an incidental finding on microscopic examination
  • May be associated with pelvic pain, especially in the setting of pelvic inflammatory disease, endometriosis or tubal ectopic pregnancy
Radiology description
  • May show hydrosalpinx, unilateral or bilateral
Case reports
  • Treating the underlying infection / inflammation if there is concurrent acute salpingitis
Gross description
  • Fused fimbriae, causing blunted end (clubbed tube)
  • May form significant tubo-ovarian adhesions and a conglomerated mass
  • May show marked tubal dilation (hydrosalpinx)
  • May show areas of hemorrhage if associated with endometriosis
Gross images

AFIP images
Discolored mucosa

Discolored mucosa

Microscopic (histologic) description
  • Chronic salpingitis (Fertil Steril 2000;74:152):
    • Usually short, thick plicae with fibrous stroma, lymphocytes, plasma cells or both in the mucosa
    • Hydrosalpinx may or may not be seen
    • Plicae may look normal or fused
    • Epithelial hyperplasia may be seen
    • Granulomas, either necrotizing or nonnecrotizing, suggest infection (especially tuberculosis), sarcoidosis or other autoimmune disease (e.g., inflammatory bowel disease)
  • Pseudoxanthomatous salpingitis (Int J Gynecol Pathol 2015;34:275):
    • Abundant hemosiderin laden macrophages within fallopian tube lamina propria with associated lymphoplasmacytic infiltrate
    • Endometriosis in the tubal subserosa or ovarian tissue
  • Xanthogranulomatous salpingitis:
    • Foamy histiocytes, granulomas and chronic inflammation in the fallopian tube submucosa (Int J Gynecol Pathol 2002;21:56)
    • May be associated with pelvic inflammatory disease
  • Follicular salpingitis (misnomer): later stage of chronic salpingitis with fusing plicae, mimicking a pattern of thyroid follicles
Microscopic (histologic) images

Contributed by Shabnam Zarei, M.D. and Nicole D. Riddle, M.D.

Short thick plicae

Inflammatory cells

Short thick plicae and inflammation

Mucosal inflammation

Stromal fibrosis

Thickened plicae and foamy histiocytes

Foamy histiocytes

Fused and slightly thickened plicae

Fused and slightly thickened plicae

Sample pathology report
  • Fallopian tube, salpingectomy:
    • Chronic salpingitis, xanthogranulomatous salpingitis or pseudoxanthomatous salpingitis
Differential diagnosis
  • Fibrotic plica:
    • A normal physiologic change in postmenopausal women
    • Inflammatory infiltrate is absent
  • Physiologic salpingitis during menses:
    • Only minimal neutrophilic infiltrate is seen
  • Salpingitis isthmica nodosa:
    • Nodular thickening of fallopian tube with cystically dilated glands within muscular layer
    • No associated inflammation
  • Serous tubal intraepithelial carcinoma (STIC):
    • Older women
    • Cytologic atypia and loss of ciliation
    • Abnormal (mutant) pattern of p53 expression by immunohistochemistry
Board review style question #1
Which of the following is the most common finding associated with pseudoxanthomatous salpingitis?

  1. Endometriosis
  2. History of prior pelvic surgery
  3. Inflammatory bowel disease and diverticulosis
  4. Pelvic tuberculosis
Board review style answer #1
A. Endometriosis. Answer B is incorrect because prior pelvic surgery is not associated with pseudoxanthomatous salpingitis. Answer C is incorrect because inflammatory bowel disease and diverticulosis can be seen in association with pulse granuloma and chronic salpingitis. Answer D is incorrect because pelvic tuberculosis is associated with granulomatous salpingitis.

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Reference: Chronic salpingitis
Board review style question #2

Which of the following statements is true regarding the photomicrograph above?

  1. Associated hydrosalpinx is uncommon
  2. Rarely seen in ectopic tubal pregnancy
  3. The most common inflammatory infiltrates are neutrophils and eosinophils
  4. When associated with endometriosis, it has distinct gross and microscopic findings
Board review style answer #2
D. When associated with endometriosis, it has distinct gross and microscopic findings. Answer A is incorrect because hydrosalpinx is common. Answer B is incorrect because this can be seen in half of ectopic tubal pregnancy. Answer C is incorrect because plasma cells and lymphocytes are usually present in the submucosa.

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Reference: Chronic salpingitis
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