Diseases of the fallopian tube
- Lesion
The tube is small but busy: infection scars it, cysts hang from it, and its fimbriae are where most ovarian high-grade serous cancers really begin.
What it is
Most diseases of the fallopian tube are inflammatory. Suppurative salpingitis is part of pelvic inflammatory disease, and tuberculous salpingitis is a granulomatous form important where tuberculosis is common; both heal with scarring that causes infertility and ectopic pregnancy. Paratubal cysts and the hydatid of Morgagni are common harmless remnants, and the adenomatoid tumour is a small benign mesothelial nodule. The tubal fimbria is now recognised as the origin of most high-grade serous carcinomas once called ovarian.
Structure
- Acute salpingitis: swollen, red tube with neutrophils in the mucosa and pus in the lumen.
- Hydrosalpinx: a dilated thin-walled tube filled with clear fluid, its plicae flattened or fused into a network.
- Tuberculous: enlarged, sometimes beaded tube with caseating granulomas in the mucosa and wall.
- Paratubal cyst: a smooth translucent cyst lined by a single layer of tubal-type epithelium.
- Adenomatoid tumour: gland-like and slit-like spaces lined by flat to cuboidal mesothelial cells (calretinin and WT1 positive).
Step by step
- Bacteria ascend from the cervix, or mycobacteria arrive by blood.
- Inflammation destroys ciliated epithelium and fills the lumen with exudate.
- Fibrosis fuses the plicae and closes the fimbrial end; secretions accumulate (hydrosalpinx).
- Damaged tubes fail to transport the ovum and embryo: infertility or ectopic pregnancy.
Clinical notes
- Tubal factor infertility is often the first sign of a silent past chlamydial infection.
- Removing both tubes (salpingectomy) at other pelvic surgery is used to reduce the future risk of high-grade serous carcinoma.
- Paratubal cysts are usually incidental but can twist and cause acute pain.
Test yourself
Think of the answer, then tap the question to see it.
What is a hydrosalpinx?
A tube distended with clear fluid after chronic salpingitis has closed the fimbrial end and flattened the plicae.
Where do most pelvic high-grade serous carcinomas begin?
In the fimbria of the fallopian tube, as serous tubal intraepithelial carcinoma.
How does tuberculosis reach the fallopian tube?
By the blood stream from a primary focus, usually the lung; it causes caseating granulomatous salpingitis.
Elsewhere in DurgiPedia
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Pelvic Inflammatory Disease (StatPearls (NCBI Bookshelf), 2026); Ovarian Epithelial, Fallopian Tube, and Primary Peritoneal Cancer Treatment (PDQ®)–Health Professional Version (National Cancer Institute, 2026).
Spotted a mistake?We are always improving for the community. Tell us what is wrong and our team will review it.Report a mistake
Representative model, for educational purposes only.