Home | About CytoJournalEditorial Board | Archived articles | Search CytoJ Articles | Subscribe | Peer review policies | CytoJournal Quiz Cases
  Reviewer corner | Author corner | OA Steward’s corner | CF member’s corner | Join as CF member | Manuscript submission | Open Access (OA) Advocacy
Home
CytoJournal All 'FULL TEXT' in HTML are FREE under "open access" charter of CytoJournal.
To login for downloading any PDF OR to request TOC (Table of Content) by e-mail, please click here
Home Email this page Print this page Small font size Default font size Increase font size Cytopathology Foundation
Navigate here
  Search
 
 » Next article
 » Previous article 
 » Browse articles
  
Resource links
 »  Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »  Article in PDF (931 KB)
 »  Citation Manager
 »  Access Statistics
 »  Reader Comments
 »  Email Alert *
 »  Add to My List *
* Registration required (free)  

 
  In this article
 »  References
 »  Article Figures

 Article Access Statistics
    Viewed4939    
    Printed45    
    Emailed0    
    PDF Downloaded165    
    Comments [Add]    
    Cited by others 3    

Recommend this journal

 


 
COMMENTARY
CytoJournal 2005,  2:20

Primary fallopian tubal transitional cell carcinoma with exfoliation of malignant cells in cervical Pap smear


1 Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Obstetrics and Gynecology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Date of Submission19-Jun-2005
Date of Acceptance09-Dec-2005
Date of Web Publication09-Dec-2005

Correspondence Address:
Raje Nijhawan
Department of Cytology and Gynecological Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


PMID: 16336674

Rights and PermissionsRights and Permissions



How to cite this article:
Gupta N, Srinivasan R, Nijhawan R, Dhaliwal LK. Primary fallopian tubal transitional cell carcinoma with exfoliation of malignant cells in cervical Pap smear. CytoJournal 2005;2:20

How to cite this URL:
Gupta N, Srinivasan R, Nijhawan R, Dhaliwal LK. Primary fallopian tubal transitional cell carcinoma with exfoliation of malignant cells in cervical Pap smear. CytoJournal [serial online] 2005 [cited 2017 Nov 24];2:20. Available from: http://www.cytojournal.com/text.asp?2005/2/1/20/41250


Only 0.2 - 0.5% of primary female genital malignancies are tubal, and histologically most of these are adenocarcinomas. Primary transitional cell carcinoma (TCC) accounts for about 10% of primary tubal carcinomas. [1] Primary TCC of the  Fallopian tube More Details with exfoliation of malignant cells in cervical  Pap smear More Details has not been described in the literature previously.

A 52-year- old lady presented with episodic spotting per vaginum. On general physical examination, the only significant finding was a 1.5 cm, firm, mobile, left supraclavicular lymph node. Fine needle aspiration (FNAC) from the left supraclavicular lymph node showed a metastatic carcinoma. The patient was investigated for detection of the primary malignancy. She was referred to the gynecologist, who took a cervical Pap smear. The Pap smear revealed mainly clusters as well as scattered cells showing moderate pleomorphism [Figure 1]. The cells had moderate amount of cytoplasm, coarsely clumped granular chromatin and inconspicuous nucleoli. It was reported as positive for squamous cell carcinoma by the cytopathologist, who also advised colposcopy and biopsy confirmation. Colposcopical examination of the cervix was performed which showed no significant abnormality. A cervical biopsy and endocervical curettage were done. On microscopic examination, the endocervical curettage showed an occasional cluster of malignant cells entangled in mucus. The endocervical curettage was reported as suspicious of malignancy. The cervical biopsy was unremarkable. A repeat Pap smear also showed malignant cells as described previously. In view of the persistently positive Pap smear report, a total abdominal hysterectomy with bilateral salpingo-oophrectomy was carried out and the specimen was sent for histopathological examination.

Grossly, the cervix, endo- myometrium, bilateral ovaries and left fallopian tube were unremarkable. The right fallopian tube showed a nodule measuring about 2.5 × 2 × 2 cm occluding its fimbrial end. The cut section of this nodule was gray-white. Microscopically, a tumor was identified in the right fallopian tube. In one focus, a clump of tumor cells was seen in its lumen. The tumor showed large areas of necrosis. The tumor cells were arranged predominantly in ribbons, trabeculae and sheets [Figure 2]. Histologicaly, this tumor pattern was that of a transitional cell carcinoma. The cells had "coffee bean" like nuclei and prominent nucleoli. There was no evidence of keratinisation. Mitosis was increased and the tumor was seen infiltrating transmurally. In addition, a small serosal tumor deposit was seen in the uterus.

Primary transitional cell carcinoma (TCC) of the fallopian tube is rare. The typical signs and symptoms of invasive tubal carcinoma include vaginal bleeding, clear or serosanguinous vaginal discharge, pelvic pain and a pelvic mass. The cervical Pap smear has shown exfoliated malignant cells rarely in cases of adenocarcinoma of fallopian tube. [1-5] Grossly, the tubal lumen is usually filled and dilated by papillary or solid and necrotic tumor. Tumor at the fimbriated end, with ready access to the peritoneal cavity, may also warrant individual staging. The morphology of TCC in fallopian tube is similar to TCC of urinary bladder. To the best of our knowledge, there are less than twenty cases reported of primary TCC in the fallopian tube in the English literature[6-8]. Primary TCC of fallopian tube showing exfoliated malignant cells in cervical Pap smear has not been described in the literature previously. Therefore, if the cervical Pap smear is positive for malignant cells and the cervical biopsy is negative, the patient should be investigated for a malignancy higher up in the gynecological tract. If endometrial curettage also does not reveal malignancy, the possibility of a tubal malignancy must be excluded by appropriate investigations.[Figure 3]



 
 » References Top

1.Kim JW, Cho EM, Kim YT, Han JH: A case of primary transitional cell carcinoma of the fallopian tube. J Obstet Gynaecol Res 1999, 25: 321-6.  Back to cited text no. 1    
2.Johnston GA Jr: Primary malignancy of the fallopian tube: a clinical review of 13 cases. J Surg Oncol 1983, 24: 304-9.   Back to cited text no. 2    
3.Safret A, Bosch B, Bannwart F, Rinderknecht B, Hafner HU: Carcinoma in situ of the fallopian tube presenting as a positive Pap smear. Acta Cytologica 2004, 48 (3) : 462-4.   Back to cited text no. 3    
4.Rahimpanah F, Reid R: Fallopian tube carcinoma detected by ThinPrep cytology smear. Med J Aust 2000, 172: 38.  Back to cited text no. 4    
5.Warshal DP, Burgelson ER, Aikins JK, Rocereto TF: Post- hysterectomy fallopian tube carcinoma presenting with a positive Papanicolaou smear. Obstet Gynecol 1999, 94: 834-6.  Back to cited text no. 5    
6.Koshiyama M, Konishi I, Yoshida M, Wang DP, Mandai M, Mori T, Fujii S: Transitinal cell carcinoma of the fallopian tube: a light and electron microscopic study. Int J Gynecol Pathol 1994, 13: 175-80.  Back to cited text no. 6    
7.Takeuchi S, Hirano H, Ichio T, Taniguchi H, Toyoda N: A case report: rare case of primary transitional cell carcinoma of the fallopian tube. J Obstet Gynaecol Res 1999, 25: 29-32.  Back to cited text no. 7    
8.Rabczynski J, Kochman A, Hudziec P: Primary transitional cell carcinoma of the fallopian tube. Przegl Lek 1998, 55: 572-5.  Back to cited text no. 8    


    Figures

  [Figure 1], [Figure 2], [Figure 3]

This article has been cited by
1 CytoJournal′s move to the new platform: More on financial model to the support open-access charter in cytopathology, publication quality indicators, and other issues
Shidham, V., Pitman, M., Demay, R., Atkinson, B.
CytoJournal. 2008; 5(art 15)
[Pubmed]
2 The best in CytoJournal: 2005
Cohen, M.B.
CytoJournal. 2006; 3: Art 21
[Pubmed]
3 Thank you reviewers- CytoJournal 2006
Shidham, V.B., Atkinson, B.F.
CytoJournal. 2006; 3
[Pubmed]



 

Top
Previous article Next article

    

  Site Map | Copyright and Disclaimer
© 2007 - CytoJournal | A journal by Cytopathology Foundation Inc with Wolters Kluwer - Medknow
New version online since 1st July '08
Open Access