Table 2.
Tubal precursor lesions.
| Precursor Lesions | Epidemiology | Clinical Presentation | Diagnostic Aspects Hematoxylin and Eosin | Immunohistochemistry | Evolution |
|---|---|---|---|---|---|
| STIC Serous tubal intraepithelial carcinoma |
Found in 4% of tubes in patients undergoing salpingectomy for non-neoplastic indications | Usually asymptomatic, occasional diagnosis during salpingectomy or salpingo-oophorectomy | * -Irregular luminal surface -Epithelial stratification -Cellular or nuclear pleomorphism -Nuclear enlargement -Nuclear hyperchromasia -Mitotic figures, prominent nucleoli and/or apoptotic bodies |
p53 mutant type and a high Ki-67/MIB-1 index (≥10%) | HGSC ovarian carcinoma in 10% Time to carcinoma progression: 7 years |
| STIL Serous intraepithelial lesion of the fallopian tube |
Found in 9% of tubes in patients undergoing salpingectomy for non-neoplastic indications | Usually asymptomatic, occasional diagnosis during salpingectomy or salpingo-oophorectomy | Resembles STIC but shows less than three features required for STIC diagnosis on hematoxylin and eosin staining | p53 negative and/or low Ki-67 | Possibile “precursor escape” |
| TILT Tubal intraepithelial lesion in transition |
Found in 3.2% of tubes in patients undergoing salpingectomy for non-neoplastic indications | Usually asymptomatic, occasional diagnosis during salpingectomy or salpingo-oophorectomy | Resembles STIC but shows less than three features required for STIC diagnosis on hematoxylin and eosin staining | p53 negative and/or low Ki-67 | When diagnosed in isolation, remains unclarified |
| SCOUT Secretory or stem cell outgrowths |
Found in 45% of tubes in patients undergoing salpingectomy for non-neoplastic indications | Usually asymptomatic, occasional diagnosis during salpingectomy or salpingo-oophorectomy | Linear segments with continuous population of ≥30 secretory cells without intervening ciliated cells | Bcl-2 ** positivity in ≥30 cells Not associated with p53 mutation |
Although there is no evidence that they are directly related, there is an increased rate in women with serous carcinoma |
| p53 SIGNATURE | Found in 2% of tubes in patients undergoing salpingectomy for non-neoplastic indications | Usually asymptomatic, occasional diagnosis during salpingectomy or salpingo-oophorectomy | No clear cytomorphological atypia on hematoxylin and eosin staining |
Morphologically normal epithelium with aberrant p53 staining pattern in at least 12 adjacent cells |
Early event in the pathway to serous carcinoma |
* At least 3 of these features on hematoxylin and eosin staining are required to diagnose STIC. ** B-cell lymphoma 2.