Pseudoxanthomatous salpingitis: An uncommon lesion of the fallopian tube

Dr Faten LIMAIEM and Dr Ahmed HALOUANI prepared, organized, wrote, and edited all aspects of the manuscript. Dr Faten LIMAIEM prepared all of the histology figures in the manuscript. Pr Kaouther DIMASSI participated in the conception and design of the study, the acquisition of data, analysis, and interpretation of the data. All authors contributed equally to preparing the manuscript and participated in the final approval of the manuscript before its submission.

All procedures performed were in accordance with the ethical standards. The examination was made in accordance with the approved principles.

A 49‐year‐old woman gravida 4 para 4, presented with a two‐month history of pelvic pain. Physical examination did not disclose pelvic tenderness or palpable masses. Pelvic ultrasound examination showed fluid‐filled dilatation of the left fallopian tub e and a bilocular heterogeneous cyst of the left ovary measuring 4.3 × 4.9 cm (Figure  1A ). The patient underwent left salpingo‐oophorectomy. Grossly, the ovarian cyst was filled with brown material and the fallopian tube was dilated. Histologically, we noted the presence in the lamina propria of the fallopian tube of numerous pigmented histiocytes (Figure  1B–D ). Their cytoplasm was filled with coarse cytoplasmic granules of hemosiderin appearance. 1 There were a few foamy histiocytes with vacuolated cytoplasm. Some lymphocytes were intermingled with the histiocytes. The ovarian cyst was lined by an endometrial epithelium with underlying endometrial stroma. 1 The latter contained aggregates of pigmented or hemosiderin‐laden histiocytes (Figure  2A, B ). The final pathological diagnosis was PXS associated with an endometriotic cyst. The postoperative course was uneventful. Currently, the patient is monitored on an outpatient basis with a follow‐up period of 2 months. (A) Pelvic ultrasound examination showed fluid‐filled dilatation of the left fallopian tub e and a bilocular heterogeneous cyst of the left ovary measuring 4.3 × 4.9 cm. (B) Cross section of the fallopian tube, showing distended plicae with pigmented histiocytes, in the lamina propria, (Hematoxylin and eosin, magnification ×100). (C) The lamina propria of the fallopian tube contains numerous pigmented histiocytes, (Hematoxylin and eosin, magnification ×200). (D) At higher power, pseudoxanthomatous salpingitis is characterized by filling of the tubal lamina propria with macrophages containing finely granular brown pigment. The macrophages are intermixed with lymphocytes, (Hematoxylin and eosin, magnification ×400) (A) Endometriotic cyst lined by endometrial epithelium with underlying endometrial stroma and aggregates of pigmented or hemosiderin‐laden histiocytes. (Hematoxylin and eosin, magnification ×100). (B) Endometriotic cyst: aggregates of pigmented or hemosiderin‐laden histiocytes in the cyst wall (Hematoxylin and eosin, magnification ×400)

Published with written consent of the patient.

None declared.