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23 Fallopian tubes: Tuberculosis

Tuberculosis salpingitis
Age/sex: 26-year-old female
Size: 14.4 x 21.0 x 7.2 cm
The specimen shows two greatly enlarged Fallopian tubes. A cut-away of one shows it to be filled with more or less uniform, tan-colored (caseous) material (C). The tubes were surgically removed from a young patient with a six-month history of pelvic pain.


Tuberculosis salpingitis

Mycobacteria – the causative organism of tuberculosis – often spread throughout the body during their initial (“primary”) infection in the lung (see Specimen 12). Although such spread usually does not result in disease –the organisms are often effectively killed at the site to which they spread – the infection occasionally remains inapparent until it “reactivates” months or years later. For reasons that are unclear, some organs are more likely to be affected in this way than others. The Fallopian tube is one of these.

The infection first affects the inner (mucosal) surface of the tube, which shows granulomatous inflammation histologically. Necrotic (caseous) material accumulates within the lumen, sometimes causing significant enlargement such as in the specimen shown. In time, the infection can extend to the serosal surface and cause fibrous adhesions to the surrounding tissue. Extension of infection to the adjacent ovary and uterus (endometrium) is also frequent.

The condition is uncommonly seen in “developed” countries, where the prevalence of tuberculosis is low; however, it is not rare elsewhere. Young to middle-aged women are most often affected. The usual “symptom” is infertility. The patient may also complain of pelvic pain and menstrual irregularities.

The Fallopian tube is named after the Italian priest and anatomist Gabriele Falloppio (1523 – 1562). He was particularly interested in the head and described several anatomical features of the middle and inner ears as well as the sinuses of the skull bones. He also gave a detailed description of the organ to which his name has been associated.

Below: An engraving of Gabriele Fallopio.

Source: Unknown. (1688). Gabriele Fallopio [engraving]. Wellcome Collection.

An engraving of Gabriele Fallopio.

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