Author Information
Abstract
The human fallopian tubal wall has three serosa on the outside, smooth muscular layer in the middle and mucosa on the outside. The serosa is peritoneum. The mucosa is of columnar and ciliated epithelium. There is no fat in the fallopian tube. A case is presented here showing fat under the serosa of both the fallopian tubes in the distal part. This is the first case report of this condition in the world literature.
Introduction
The human fallopian tube has mesothelium on the outside (serosa), smooth muscle in the middle, and columna, ciliated epithelim lining the inside (mucosa). It does not normally contain any fat. Ectopic tissues tissues may be found in the fallopian tube at times, but fat is not one of them. A patient with primary infertility was found to have fat in the distal part of each fallopian tube during laparoscopy.
Case Report
A 23 year old woman presented for evaluation and management for primary infertility. She has been married for 2 years, and the couple had not used any contraception during the 2 years of cohabitation. Her menstrual cycles were every 28-30 days, regular, and associated with moderate flow. Her medical, surgical, sexual, and personal history was not contributory. Her general and systemic examination revealed no abnormality. Bimanual pelvic examination showed an anteverted, normal sized uterus, and no abnormality. Her husband's semen analysis showed normal findings. Her fasting and postpradndial plasma sugar levels, liver function tests, renal function tests, serum TSH were normal. Her ovulation study by ultrasonography showed spontaneous ovulation. A laparoscopy was performed, which showed normal uterus, ovaries, urinary bladder, bowel, and peritoneum. The fallopian tubes were normal in size and shape, but had fat under the serosa in their distal one-third portions. Chromopertubation showed that they were patent.
Figure 1. Left fallopian tube and ovary.
Figure 2. Left fallopian tube and ovary.
Discussion
The human fallopian tubal wall has three serosa on the outside, smooth muscular layer in the middle and mucosa on the outside. The serosa is peritoneum. The mucosa is of columnar and ciliated epithelium. Fallopian tube does not contain any fat.[1] Ectopic tissue like hilus cells may occur in the fallopian tube and paratubal tissue.[2,3] Adrenal cortical tissue has been found in the broad ligament.[4] Ectopic pancreatic tissue has also been reported in the fallopian tube.[5] However presence of fat has not been reported in the tube, except as a tumor (lipoma).[6-8] However the distribution of fat was uniform and the surface was smooth in our case, which ruled out a lipoma. Hence a biopsy was not done. This case is reported to bring to notice an anatomical variation, and also to make readers aware that it is not a disease, when such a finding is seen coincidentally.
Acknowledgment
I thank Dr Sarika Solanke for taking the intraoperative pictures.
References
- Junqueira’s Basic Histology text and Atlas. Mescher LA Editor. 13th edition McGraw Hill New York 2013 p. 461.
- Palomaki JF, Blair OM. Hilus cell rest of the fallopian tube. A case report. Obstet Gynecol 1971;37:60–62.
- Honore LH, O’Hara KE. Ovarian hilus cell heterotopia. Obstet Gynecol 1979;53:461–464.
- Falls JL. Accessory adrenal cortex in the broad ligament. Incidence and functional significance. Cancer 1955;8:143–150.
- Mason TE, Quagliarello JR. Ectopic pancreas in the fallopian tube. Report of a first case. Obstet Gynecol 1976;48:S70–S73.
- Krutsay M. Lipoma of the Fallopian tube. Magy Onkol. 2008 Mar;52(1):71-3. doi: 10.1556/MOnkol.52.2008.1.10.
- Daro, A. F. (1935). Lipoma of the fallopian tube. American Journal of Obstetrics and Gynecology, 30(5), 695.
- Tóth F, Hegyi J. Lipoma of the fallopian tube associated with dermoid cyst and endometriosis. Orv Hetil. 1971 Apr 18;112(16):927-8.
Citation
Parulekar SV. Lipid Infiltration Of Fallopian Tube. JPGO Vol 5 No. 4. Available from: http://www.jpgo.org/2018/04/lipid-infiltration-of-fallopian-tube.html