1995 Volume 34 Issue 4 Pages 666-669
We report a case of carcinoma in situ of the fallopian tube that was detected by atypical cells in a cervical smear obtained on mass screening for uterine cancer. Cervical cytology revealed large tumor cells which displayed overlapping clumps. The tumor cells had large oval nuclei with obvious anisonucleosis, high N/C ratios and fine granular chromatin, as well as prominent nucleoli. The specimen was thus diagnosed as class V, derived from adenocarcinoma. Furthermore, similar tumor cells were observed in the cytological specimens of an endometrial smear and intraperitoneal lavage. In the resected left fallopian tube, no macroscopically abnormal findings were noticed, but carcinoma in situ with increased stratification, micropapillary proliferation, nuclear atypia and abnormal mitotic figures without stromal invasion were detected histologically. The patient was treated with three courses of CAP chemotherapy after the primary operation and has been alive for 2 years and 10 months without signs of recurrence.
Carcinoma of the fallopian tube is a rare disease and preoperative diagnosis of this disease has been considered to be difficult. The present case demonstrates that it is important to take this disease into consideration in cases in whom cervical or endometrial smears reveal adenocarcinoma cells even when few or no malignant tissues are observed histologically.
