Other nonneoplastic


Topic Completed: 1 December 2017

Minor changes: 27 July 2021

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PubMed Search: Ovarian endosalpingiosis

Aurelia Busca, M.D., Ph.D.
Carlos Parra-Herran, M.D.
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Cite this page: Busca A, Parra-Herran C. Endosalpingiosis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarynontumorendosalpingiosis.html. Accessed October 17th, 2021.
Definition / general
  • Presence of ectopic glands in the ovary lined by fallopian tube type ciliated epithelium
Essential features
  • Incidental finding in resection specimens
  • Diagnosed by microscopic examination
  • Defined as ectopic glands lined by fallopian tube type ciliated epithelium outside the fallopian tube
  • Most Müllerian type epithelial inclusion cysts are within the spectrum of endosalpingiosis
  • When mass forming, lesion is called florid cystic endosalpingiosis
  • Ovaries, fallopian tube serosa, uterine serosa, bladder, lymph nodes
  • Most cases are believed to be caused by distal fallopian tube implants in the ovarian cortex during ovulation
  • Term "papillary tubal hyperplasia" (PTH) has been proposed to describe small rounded clusters of tubal epithelial cells and small papillae, with or without associated psammoma bodies, that are present within the tubal lumen; PTH has been linked to endosalpingiosis (Am J Surg Pathol 2011;35:1605)
  • Some cases are believed to represent developmentally misplaced Müllerian tissue (Reprod Sci 2013;20:1030)
Clinical features
  • By histopathological examination, with confirmation of morphology and exclusion of endometriosis
Prognostic factors
  • Considered a benign finding
  • Relationship with development of epithelial malignancies is not clear but patients with endosalpingiosis have been found to be more likely to have concurrent endometriosis as well as uterine and ovarian cancer (Gynecol Oncol 2016;142:255)
Case reports
Clinical images

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Laparoscopy of enlarged ovary

Gross description
Gross images

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Multiple lesions

Microscopic (histologic) description
  • Glands lined by ciliated tubal type epithelium
  • Three types of cells:
    • Ciliated columnar cells
    • Nonciliated columnar secretory mucous cells
    • So called intercalary or peg cells
  • May have psammoma bodies
  • Absence of endometrial stroma
  • Glands can be cystically dilated; they are usually found in the superficial ovarian cortex, either scattered or in loose clusters
  • Variable papillae beneath the peritoneal surface
  • Microscopic (histologic) images

    Contributed by Aurelia Busca, M.D., Ph.D.


    AFIP images

    Glands lined by ciliated epithelium lie in fibrous stroma

    Ciliated, secretory and intercalated cells line cystic space

    Images hosted on other servers:

    Calretinin: polypoidal

    Positive stains
    Negative stains
    Differential diagnosis
    Additional references
    Board review style question #1
    What feature below is most important to distinguish endosalpingiosis from endometriosis?

    1. Location
    2. Presence of endometrial stroma
    3. Presence of tubal epithelium
    4. Reactivity for PAX8
    Board review style answer #1
    B. Endometrial stroma is seen in endometriosis but not endosalpingiosis. Endometriosis can have tubal differentiation. It tends to have a similar anatomic distribution as endosalpingiosis and to express markers of Müllerian derivation such as PAX8.

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    Reference: Endosalpingiosis
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