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Year : 2009  |  Volume : 52  |  Issue : 3  |  Page : 434-435
Salpingitis isthmica nodosa

Department of Pathology, SGRR Institute of Medical & Health Sciences, Dehradun, Uttaranchal, India

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Date of Web Publication12-Aug-2009

How to cite this article:
Chawla N, Kudesia S, Azad S, Singhal M, Rai S. Salpingitis isthmica nodosa. Indian J Pathol Microbiol 2009;52:434-5

How to cite this URL:
Chawla N, Kudesia S, Azad S, Singhal M, Rai S. Salpingitis isthmica nodosa. Indian J Pathol Microbiol [serial online] 2009 [cited 2021 May 13];52:434-5. Available from: https://www.ijpmonline.org/text.asp?2009/52/3/434/55019

Salpingitis isthmica nodosa is a condition of the  Fallopian tube More Details characterized by nodular thickening of the tunica muscularis of the isthmic portion of the tube enclosing cystically dilated glands leading to complete obliteration of tubal lumen. [1] It is usually bilateral and the patient presents with primary infertility or recurrent ectopic pregnancies. [2] Hysterosalpingography is diagnostic of this condition.

In the present study, a 45-year-old patient presented to the gynecology department with primary infertility and dysfunctional uterine bleeding. She had taken hormonal treatment for infertility earlier and was admitted to the hospital with complaints of menorrhagia. Total abdominal hysterectomy with bilateral salpingoophrectomy was carried out. Gross examination of the uterus revealed hyperplastic endometrium along with a small intramural leiomyoma. The isthmic end of both fallopian tubes showed a grey-white nodules measuring 1.5cm in diameter [Figure 1] and the lumen was occluded with the distal portion of tubes appearing normal. Both the ovaries showed no significant pathology. Microscopic examination of bilateral nodules at the isthmus of fallopian tubes revealed cystically dilated glands surrounded by hypertrophic muscular layer with complete obliteration of tubal lumen [Figure 2].The glands were lined by ciliated columnar epithelium [Figure 3]. Few of the glands were seen infiltrating the muscular layer. Microscopic examination of uterine corpus showed endometrium displaying features of complex hyperplasia without atypia. Salpingitis isthmica nodosa involves women in the age group of 25-60 years with average age at diagnosis being 30 years. The etiology of this condition is unknown, possible causes are post-inflammatory distortion and adenomyosis-like process. [3] Microscopic examination of the nodule shows dispersed glands of tubal epithelium surrounded by broad bands of muscularis. [4] On hysterosalpingography, diagnosis may be confused with tubal endometriosis, however, presence of tubal epithelium lining the glands on histopathological examination rules out endometriosis. [5] Complex endometrial hyperplasia seen in our case could be attributed to hormonal treatment taken for infertility. The complications of salpingitis isthmica nodosa are infertility and recurrent ectopic pregnancies and hence, salpingitis isthmica nodosa is an important cause to be ruled out in such cases. [2]

   References Top

1.Jenkins CS,Williams SR,Schmidt GE.Salpingitis isthmica nodosa: A review of literature, discussion of clinical significance and consideration of patient management. Fertil Steril 1993;60:599-607.  Back to cited text no. 1  [PUBMED]  
2.Majumdar B,Henderson PH, Semple E. Salpingitis isthmica nodosa: A high risk for tubal pregnancy. Obstet Gynecol Surv 1983;62:73-8.  Back to cited text no. 2    
3.Green LK, Kott ML. Histopathologic findings in ectopic tubal pregnancy. Int J Gynecol Pathol 1989;8:255-62.  Back to cited text no. 3  [PUBMED]  
4.Benjamin CL, Beaver DC. Pathogenesis of salpingitis isthmica nodosa. Am J Clin Pathol 1951;21:212- 22.  Back to cited text no. 4  [PUBMED]  
5.McComb PF, Rowe TC. Salpingitis isthmica nodosa: Evidence it is a progressive disease. Fertil Steril 1989;51:542-5.  Back to cited text no. 5  [PUBMED]  

Correspondence Address:
Nitin Chawla
124/7, Rajender Nagar, Street-4, Lane-8, Dehradun, Uttarakhand - 248 001
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0377-4929.55019

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  [Figure 1], [Figure 2], [Figure 3]

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