Objective: To investigate the clinical and pathological characteristics of primary mucinous gland lesions of the fallopian tubes. Methods: The clinical data, pathomorphological characteristics and immunophenotype of 14 cases of primary mucinous gland lesions of the fallopian tube diagnosed at Obstetrics and Gynecology Hospital of Fudan University from 2015 to 2023 were analyzed retrospectively. In addition, a comprehensive review of relevant literature was conducted. Results: The age of 14 patients ranged from 53 to 83 years, with an average of 65 years. Among them, 13 cases exhibited unilateral involvement while one case showed bilateral presentation. Nine cases were mucinous metaplasia of the fallopian tube, four cases were invasive mucinous adenocarcinoma and one case was mucinous carcinoma in situ. Morphologically, mucinous metaplasia of the fallopian tube was focal, with or without inflammation. The cells of mucinous adenocarcinoma or mucinous carcinoma in situ exhibited characteristics indicative of gastrointestinal differentiation. Immunohistochemical analysis revealed diffuse positive expression of CK7, and negative expression of SATB2. CDX2 demonstrated positive staining in two cases. One case exhibited diffuse and strongly positive mutant expression of p53, whereas the remaining cases displayed wild-type expression. MUC6 showed diffuse or focally positive staining in mucinous gland lesions characterized by gastric differentiation. Some cases of mucinous adenocarcinoma of fallopian tube were subject to AB-PAS staining, resulting in red to purple cytoplasmic staining. Conclusions: Primary mucinous lesions of the fallopian tube are exceedingly uncommon. All cases of mucinous adenocarcinoma of fallopian tubes in this study exhibit the morphology and immunohistochemical characteristics of gastrointestinal differentiation. Mucinous metaplasia of the fallopian tube is a benign lesion of incidental finding, which is closely related to inflammation or gastric differentiation. Mucinous lesions of cervix, ovary and digestive tract are excluded in all patients, confirming the independent existence of mucinous lesions within fallopian tubes.
目的： 探讨输卵管原发性黏液腺体病变的临床病理学特征。 方法： 回顾性分析复旦大学附属妇产科医院2015—2023年诊治的14例输卵管原发性黏液腺体病变的临床资料、病理形态学特征及免疫表型特点，并复习相关文献。 结果： 14例患者年龄53~83岁，平均65岁。13例为单侧，1例为双侧。9例为输卵管黏液上皮化生，4例为浸润性黏液腺癌，1例为黏液性原位癌。镜下观察，输卵管黏液上皮化生呈局灶性，伴或不伴有炎症。输卵管黏液腺癌或原位癌细胞具有胃肠型分化的黏液上皮特征。免疫组织化学显示所有病例细胞角蛋白（CK）7均阳性，SATB2均阴性。2例CDX2阳性表达，1例局灶表达CK20。1例p53呈弥漫强阳性突变型表达，余均呈野生型表达。伴有胃型分化的黏液腺体病变MUC6弥漫或局灶阳性。部分输卵管黏液腺癌行阿辛蓝-过碘酸雪夫染色，细胞质呈红至紫红色。 结论： 输卵管原发性黏液性病变非常罕见，本组输卵管黏液腺癌均见胃肠型分化形态及免疫组织化学特征，输卵管黏液上皮化生为偶然发现的良性病变，与炎症或胃型分化相关。所有患者均排除宫颈、卵巢及消化道黏液性病变，从而证实输卵管黏液性病变是可以独立存在的。.