Endosalpingiosis of the Urinary Bladder: A Case of Probable Implantative Origin With Characterization of Benign Fallopian Tube Immunohistochemistry

Abstract

Müllerianosis of the bladder is an infrequently described lesion consisting of multiple Müllerian-type tissues within the urinary bladder. Few previous cases of pure endosalpingiosis have been described. Here we present a 54-year-old post-menopausal female with a history of prior pelvic surgery with traumatic bladder injury, who was found to have a cystic lesion in the posterior wall of the bladder. Routine histology demonstrated cyst epithelium characteristic of endosalpingiosis. Three benign Fallopian tube specimens were obtained and stained with the relevant immunohistochemical markers for comparison. Results showed an identical immunohistochemical profile between the bladder cyst lining and the normal Fallopian tube controls. This case represents a rare instance of pure endosalpingiosis of the urinary bladder, with a likely implantative origin. This form of bladder Müllerianosis should therefore be considered within the differential diagnosis of cystic lesions of the bladder.

Cutaneous Inguinal Scar Endosalpingiosis and Endometriosis

“…Epithelium of normal fallopian tube and in urinary bladder endosalpingiosis shows CK7 positivity and CD10 negativity, 66 similar to our case of cutaneous endosalpingiosis. We also showed positivity for WT1 in ectopic endometrial stroma and tubal epithelium.…”

“…23,30,31,36,44,56,58 Combination of ER-, PR-, and CD10 immunopositivity in stromal cells could be helpful only when the stromal component of endometriosis is present. 54 PR immunoreactivity has also been proven in normal tubal epithelium and endosalpingiosis of urinary bladder, 66 and cutaneous endosalpingiosis shows no difference.…”

Florid, Papillary Endosalpingiosis of the Axillary Lymph Nodes

“…Endosalpingiosis is a benign lesion that differentiates in the peritoneum and lymph nodes of women a tubal‐like epithelium. ES is usually described in subdiaphragmatic locations involving the female genital tract (1,17), peritoneum (18), lymph nodes, (6,19) and other abdominal organs (20–22). However, its similarity with the lining of the fallopian tubal is not complete, since intercalary cells are frequently lacking and cilia can be absent, as we were able to demonstrate in this paper using an antibody specific for the basal plate of cilia.…”

Facts about Endosalpingiosis

“…Then, freed tubal cells are shed and seeded in any tissues and organs in the pelvic cavity. The slow growth of seeded cells may develop into ectopic epithelial inclusions [10]. The theory of tubal cell origin is plausible in that it is able to explain why the lesion is exclusively seen in women [14]; and why the lesion is most frequently seen in the ovaries [15].…”