Malignant transformation of endocervicosis or endosalpingiosis
is considerably less common and must be distinguished from malignant transformation of endometriosis.
Endosalpingiosis often occurs with either endometriosis or endocervicosis, although any combination of these 3 can be seen, warranting the term mullerianosis, when substantial amounts of each are present.
Endosalpingiosis refers to the presence of glands lined by ciliated columnar epithelium and peg cells, resembling fallopian tube mucosa.
Additionally, benign conditions such as endosalpingiosis may be extremely difficult to differentiate from borderline ovarian tumors (tumors of low malignant potential) or low-grade serous carcinomas in cytologic specimens.
The main differential diagnosis of adenocarcinoma in a peritoneal washing is reactive mesothelial cells, but endosalpingiosis and endometriosis also frequently contribute to diagnostic difficulties.
Endosalpingiosis and endometriosis can be reported as benign glandular cells.
Caution is advised to not overdiagnose endometriosis or endosalpingiosis as adenocarcinoma.
To present a brief history of this condition and describe its distinctive histology and clinical presentation, as well as to review the chief differential diagnostic considerations, to include mesothelial proliferations, endosalpingiosis, endometriosis, high-grade primary peritoneal papillary serous carcinoma, and implants from primary ovarian serous neoplasms.
Bell and Scully (5) described 25 cases originally diagnosed as PPSBT, atypical endosalpingiosis, or serous cystadenoma/cystadenofibroma with peritoneal implants.
The pathological differential diagnosis includes endometriosis, endosalpingiosis, benign reactive mesothelial proliferations such as adenomatoid tumor or florid mesothelial hyperplasia, and borderline mesothelial proliferations with similar histological features, which include benign or well-differentiated papillary mesothelioma (Table 1).
Endosalpingiosis is generally distinguished by the appearance of benign fallopian tube epithelium in peritoneal inclusions.
Additional pathologic findings (eg, endosalpingiosis
and relation to tumor, if pertinent) 3.