engleski

IS IT POSSIBLE TO DIAGNOSE FALLOPIAN TUBE CARCINOMA BY CYTOLOGY? CASE REPORT

OBJECTIVES: Primary fallopian tube carcinoma is among the rarest gynaecologic malignancies. It´s clinical behaviour resembles in many ways to primary ovarian carcinoma. It is usually diagnosed in advanced stages.CASE: We present a case of a 56 year-old nuliparous patient with routine Pap smear presenting atypical glandular cells. Previous normal smear was taken two years before. The latest smear, constituted of vaginal pool, cervical scrape and endocervical brush sample had no tumour diathesis. The only abnormalities were papillary clusters of malignant glandular cells. Endometrial brush cytology revealed adenocarcinoma cells, similar to those found in Pap smear. Endometrial curettage showed no endometrial pathology but suspected malignant cells of extrauterine source. The level of CA-125 marker was in the normal range. Clinical examination and pelvic ultrasound showed no pathological finding. Based on positive cytology by Pap smear, endometrial aspiration and curretage we performed diagnostic laparotomy, during which an intraoperative cytology of the Douglas pouch lavage was performed showing positive cytology (adenomalignat cells) and positive immunocytochemical stain epithelial antigen (EA by DAKO). In spite no macroscopic morphologic pathology has been found, hysterectomy and bilateral adnexectomy was performed and the pathohystologic confirmation of primary adenocarcinoma of the right fallopian tube (Gr II/III, alveo-medullar type) was done. The 1, 0x0, 7x0, 6 mm big tumour invaded more than ½ of the muscular layer but not beyond. The uterus and the ovaries showed no pathological finding with bilateral hydrosalpinges.CONCLUSION: The presented case suggests that cytological examination although not specific may be a helpful tool in the rare cases of the stage I tubal carcinoma. Cytology has inevitable role in staging of the disease by detecting positive peritoneal lavage.

carcinoma; fallopian tube; cytology

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