Pseudocarcinomatous hyperplasia of the fallopian tube:report of a case and review of literature

LI Zaifeng; CHEN Yizhao; WANG Ting

doi:10.3969/j.issn.1007-8096.2025.11.1498

Abstract：Objective To explore the clinical pathological features, immunophenotype, and differential diagnosis of fallopian tube pseudocarcinomatous hyperplasia (FTPH), in order to enhance the understanding and diagnosis of this rare lesion. Methods A retrospective analysis was conducted on the clinical characteristics and pathological data of one case of FTPH, combined with a review of related literature. Results The patient was a 26-year-old female. Transvaginal ultrasound showed a 8.7 cm × 5.7 cm × 6.9 cm anechoic mass in the right adnexa, suspected as a pelvic mass (possible tubal hydrosalpinx). She was admitted for surgery and underwent resection of the right fallopian tube. Microscopic examination revealed extensive infiltration of acute and chronic inflammatory cells throughout the entire wall of the fallopian tube, with marked thickening of the mucosal layer. The glandular structures were complex, forming cystic glands, papillary structures, and multilayered epithelial proliferation with bridging and budding. In some areas, glands were fused into a sieve-like pattern. Lymphoepithelial lesions were widely present. The glandular epithelial cells showed mild to moderate atypia, increased nuclear-cytoplasmic ratio, vacuolar nuclei, coarse and granular chromatin, and visible small nucleoli. Mitotic figures were rarely seen. There was significant fibrous stromal reaction, which compressed small glands into tear-drop or linear patterns, showing infiltrative growth. Focal atypical glands showed infiltration into the tubal muscular layer. Immunohistochemistry: proliferating glandular epithelium expressed CK7, WT1, CA125, ER, PR; p53 showed wild-type expression; p16, CEA, and vimentin were negative; Ki-67 index was 7% in hot spots. Pathological diagnosis: Proliferative salpingitis with pseudocarcinomatous hyperplasia of the fallopian tube epithelium. Conclusion FTPH is a relatively rare non-neoplastic lesion that mimics the growth pattern of tubal adenocarcinoma, representing a benign reactive hyperplasia in response to inflammation or potential tumor processes. Misunderstanding of this condition may lead to misdiagnosis as tubal adenocarcinoma during intraoperative frozen section or postoperative routine pathology. This article describes the diagnostic and therapeutic process, combining clinical history, postoperative pathological diagnosis, and immunophenotype, and conducts a retrospective study by referring to relevant literature to avoid missed or incorrect diagnoses.