Fallopian tubes & broad ligament

General

Anatomy, histology, embryology & features to report



Topic Completed: 1 March 2013

Minor changes: 17 April 2021

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: Fallopian tubes [title] "Normal anatomy histology"

Nicole Riddle, M.D.
Jamie Shutter, M.D.
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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 16th, 2021.
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
  • 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

    AFIP images

    Lumen

    Tubal epithelium



    Images hosted on other servers

    Lumenal center filled with plica surrounded by smooth muscle layers of alternating orientation

    Fimbriae are not thickened

    Simple columnar epithelium consisting largely of secretory cells and scattered ciliated cells

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