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Fallopian tubes & broad ligament

General

Anatomy, histology, embryology & features to report

Authors: Nicole D. Riddle, M.D., Jamie Shutter, M.D.

Last author update: 1 March 2013

Last staff update: 7 June 2022

Copyright: 2002-2023, PathologyOutlines.com, Inc.

PubMed Search: Fallopian tubes - normal anatomy and histology

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Table of Contents

Cite this page: Riddle N, Shutter J. Anatomy, histology, embryology & features to report. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/fallopiantubesnormal.html. Accessed September 28th, 2023.

Definition / general

Also known as oviducts, uterine tubes, salpinges (singular salpinx means 'trumpet')
Named after their discoverer, the 16th century Italian anatomist Gabriele Falloppio

Embryology

3rd week:
- Migration of primordial germ cells from yolk sac, genital ridge forms from intermediate mesoderm, cloaca forms
4th week:
- Müllerian (paramesonephric) ducts form from coelomic epithelium invaginating venterolaterally into Wolffian (mesonephric) duct and genital mesentery
- This site of invagination later becomes the tubal ostium in which the fimbriae develop; septation of the cloaca occurs
5th - 8th weeks:
- Unfused cephalic part of Müllerian ducts form fallopian tube
- Fused part forms uterus and upper vagina
In a female fetus (or male without functioning testis):
- Müllerian structures persist and Wolffian (mesonephric) duct regresses; vestiges may persist as epithelial inclusions
- Development affected by clomiphene, tamoxifen and to a lesser extent diethylstilbestrol (DES) (Hum Pathol 1987;18:1132, Hum Pathol 1982;13:190)
In a male fetus:
- Testes produce Müllerian inhibitory substance, which causes regression of Müllerian ducts and persistence of paired Wolffian (mesonephric) ducts, which form epididymis and vas deferens
- The Müllerian remant is the rudimentary appendix testis
Reference: Bhatnagar: Essentials of Human Embryology, Third Edition, 2000

Features to report

Histologic type

Grade

Size

Depth of invasion (i.e. layers of tube involved)

Location in segment of tube

Extension to adjacent tissue

Angiolymphatic invasion

Resection margins

Pathologic findings for other tissue submitted

Additional findings (salpingitis, endometriosis)

References: Arch Pathol Lab Med 1999;123:33

Features to report by organization:

Diagrams / tables

Images hosted on other servers:

Fallopian tube

Gross description

Hollow, tubular structures, bilateral, 8 - 12 cm long and 0.5 - 1.2 cm in diameter, lined by a single layer of mucosal epithelium with many folds (plica)
Extends from posterior superior uterine fundus laterally and leads to ovaries
Connected to broad ligament by mesosalpinx (double fold of peritoneum), to uterine cornu by utero ovarian ligament, to lateral pelvic sidewall by infundibulopelvic (suspensory) ligament
Arterial supply from branches of uterine and ovarian arteries, located within mesosalpinx
Nerve supply from both sympathetic and parasympathetic fibers
Sensory fibers run from T11 - T12 and L1
Lymphatic drainage to para aortic, internal iliac, external iliac, common iliac and inguinal nodes
Segments: intramural (within wall of uterus), isthmus (thick walled, narrower opening, ~ 2 cm in length), ampulla (thin walled, major portion of lateral tube, typically where fertilization occurs), infundibulum (trumpet shaped end lined by fimbriae, attaches to ovary)
Tubal ostium: opening to peritoneal cavity
Uterotubal junction: entrance to uterine cavity

Gross images

Images hosted on other servers:

Uterine attachment on upper left, fibriae on upper right

Microscopic (histologic) description

Plica: delicate folds of mucosa on inner aspect of tube, most evident in ampulla, merge with fimbriae
Mucosa: consists predominately of single layer of cells including:
- Ciliated columnar cells (~25%), most abundant in infundibulum and ampulla, estrogen increases production of cilia
- Secretory cells (~60%), nonciliated, contain apical granules and produce tubular fluid, progesterone increases their number while estrogen increases their height and secretory activity
- Intercalated cells (peg cells, < 10%), which may be inactive secretory cells
Tubal fluid:
- Contains nutrients for spermatozoa, oocytes and zygotes and promotes the capacitation of sperm by removing glycoproteins and other molecules from the plasma membrane
- Major constituents are calcium, sodium, chloride, glucose, proteins, bicarbonates, amylase, lactic acid
- Bicarbonates and lactic acid are vital to sperm's use of oxygen; also help egg develop postfertilization
- Tubal fluid flows against action of cilia; i.e. toward the fimbriated end
Formation of fallopian tubal fluid: see Reproduction 2001;121:339

Muscle layer: 3 smooth muscle layers:
- Innermost - obliquely arranged
- Middle - circular
- Outermost - longitudinal, extends into fimbriae
Serosal surface: mesothelium of visceral peritoneum

Stroma:
- Resembles fibroblasts, whorled / storiform pattern, surrounded by dense reticulin network
- Positive for SMA and desmin
Normal histologic variations:
- Intramuscular edema in 12.5% of specimens, most frequently in postpartum women
- Plical fibrosis (35.5%), epithelial vacuolization (6.6%), and epithelial tufting / stratification (3.5%) correlated with increased patient age
- Inflammatory cells are common; intramuscular mast cells (~70% of cases), plasma cells (~20%), neutrophils (10.5%), and lymphoid follicles (2.1%) (Arch Pathol Lab Med 2002;126:951)

Microscopic (histologic) images

Contributed by Nicole D. Riddle, M.D.