Intraoperative Cytology of Fallopian Tube
NN Esposito, PA Kruk, J Shutter, SV Nicosia. University of South Florida College of Medicine, Tampa, FL; Moffitt Cancer Center, Tampa, FL
Background: Tubal intraepithelial carcinoma is a potential source of epithelial ovarian cancer. Consensus must be reached on the most reliable method to procure representative tubal tissue for biological studies without interference with pathological diagnosis. The aims of the current study study were to evaluate intraoperative cytology as a tool to harvest tubal tissue for pathobiological studies and to define the baseline cytology of the native tubal epithelium.
Design: Under IRB protocol, fallopian tube (FT) tissue was harvested from 12 postmenopausal women undergoing laparotomy for benign gynecologic disorders. FT tissue was procured by cytological imprints and RPMI washings of fimbriae and intraluminal lining, respectively. Cytological preparations were intraoperatively stained by Diff-Quik® and Papanicolaou as well as immunocytochemically for evaluation of cytokeratin (CAM 5.2), Ki67 (MIB1) and p53 expression. Cell harvests were also evaluated for total number of cells (number/FT + SE) as well as for DNA, RNA and protein content (mean μg/FT).
Results: A total of 42,000 + 8,500 cells/FT was harvested with greater recovery from washings (50,000 cells) than imprints (38,000 cells). Epithelial cells were uniformly cytokeratin+ with a Ki67 proliferation index of less than 5% and no p53 overexpression. Mean nuclear protein, nuclear DNA and cytoplasmic RNA contents were 1.05μg, 0.25 μg and 0.84μg/FT. Ciliated (12-30 μm) were more frequent than mucous (12-16 μm) cell populations while intercalary cells, fibroblasts and mesothelial cells were rare or absent. Epithelial cells were single or arranged in honeycombed sheets and pseudo-papillary groups (5-30/sample and 50-500 μm in size) and displayed fine chromatin, micronucleoli and rare nuclear grooves. The extracellular background was usually proteinaceous in cell imprints, watery in washings and with microcalcifications especially in fimbrial samples.
Conclusions: This study defines baseline cytological features of intraoperatively harvested fallopian tubes relevant to diagnostic pathologists and to researchers investigating the developmental biology of epithelial ovarian cancer. Initial laboratory studies show that tubal epithelial harvest is conducive to initiation of cell culture, cell immortalization and molecular biology studies. Development of further cytological criteria for tubal intraepithelial carcinoma and precursor lesions will facilitate intraoperative diagnosis and complement cancer detection by in vivo imaging falloposcopy.
Category: Gynecologic & Obstetrics
Tuesday, March 23, 2010 1:00 PM
Poster Session IV # 140, Tuesday Afternoon