Pleura & peritoneum



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PubMed Search: Endosalpingiosis[title]

Anjelica Hodgson, M.D.
Carlos Parra-Herran, M.D.
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Cite this page: Hodgson A, Parra-Herran C. Endosalpingiosis. website. Accessed February 22nd, 2024.
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

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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

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Glandular epithelial structures

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Gland with ciliated epithelium and psammoma body

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Comparison with metastatic breast carcinoma in axillary lymph node

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Cytology description
Positive stains
Negative stains
Differential diagnosis
Board review style 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 style 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).

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Reference: Endosalpingiosis
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