Melanosis Tubae: Histogenesis and Appropriate Terminology

Abstract

We report 2 cases of abnormal localized deposition of lipofuscin-laden macrophages in the lamina propria of the fallopian tube. In both cases there was evidence of ovarian and tubal endometriosis. The authors propose the term "melanosis tubae" (MT) as the most appropriate terminology in the diagnosis of the disease, whose pathogenesis is similar to that occurring in gastrointestinal tract pigmented conditions. The lesion is not of an inflammatory nature so that the term "pseudoxanthomatous salpingitis" is inaccurate and should not be used. Other definitions such as "pseudoxanthomatous salpingiosis," "pigmentosis salpingiosis," "pigmentosis tubae" may be used, but these are descriptive terms that are not suitable for denoting histogenesis. None of the previously reported MT cases showed coexisting tubal endometriosis. Our cases are the first examples of MT associated with tubal endometriosis.

The Spectrum of Grossly Visible Pigmented Lesions in the Uterine Cervix

“…According to a major medical dictionary, melanosis is defined as '' abnormal dark brown or brown-black pigmentation of various tissues or organs, as the result of melanin or, in some situations, other substances that resemble melanin to varying degree'' (46), whereas lentigo is a lesion with '' increased melanocytes and melanin pigment in the basal cell layer'' (47). In the gynecologic literature, peritoneal melanosis (48) has been used to describe the deposition of melanin in the peritoneum without associated melanocytes, whereas melanosis tubae (49) was reported as lipofuscin-laden macrophages in the fallopian tubes. Ironically, all cases of melanosis of the UC reportedly exhibited basal hyperpigmentation associated with an increase of melanocytes, whereas the 2 cases of cervical lentigo/ephelis merely described melanin deposition in the basal layer without any melanocytes (Table 2) so that the majority of this type of pigmented lesion in the UC probably should have been classified as lentigo instead of melanosis.…”

Pseudoxanthomatous salpingitis: Report of two cases with distinctive microscopical findings

“…Pseudoxanthomatous salpingitis (PXS) is an uncommon entity with less than 20 cases reported in English litterature 1–11 . Multiple terms as pigmentosis tubae, 1,5,6 xanthogranulomatous salpingingitis, 3,7–9 PXS, 2,7,9,11 pseudoxanthomatous salpingiosis 4 xanthogranuloma or inflammatory pseudotumor, 7 and melanosis tubae 10 have been used to designate this disease. PXS is characterized by numerous histiocytes containing brown lipofuscin‐ceroid pigment within the lamina propria of the tube, along with other chronic inflammatory cells 1–11 .…”

“…Multiple terms as pigmentosis tubae, 1,5,6 xanthogranulomatous salpingingitis, 3,7–9 PXS, 2,7,9,11 pseudoxanthomatous salpingiosis 4 xanthogranuloma or inflammatory pseudotumor, 7 and melanosis tubae 10 have been used to designate this disease. PXS is characterized by numerous histiocytes containing brown lipofuscin‐ceroid pigment within the lamina propria of the tube, along with other chronic inflammatory cells 1–11 . In most cases it is associated with ovarian endometriosis (OE) 2,4 , 6–11 but other entities as pelvic inflammatory disease, 5–7,9 intrauterine contraceptive device 8,9 and radiotherapy 1 have also been related with the development of PXS.…”

“…PXS is characterized by numerous histiocytes containing brown lipofuscin‐ceroid pigment within the lamina propria of the tube, along with other chronic inflammatory cells 1–11 . In most cases it is associated with ovarian endometriosis (OE) 2,4 , 6–11 but other entities as pelvic inflammatory disease, 5–7,9 intrauterine contraceptive device 8,9 and radiotherapy 1 have also been related with the development of PXS. The pathogenesis of PXS is not clear, although different ways have been proposed to explain the histiocytic infiltrate in tubarian plicae 4–10 .…”

“…In most cases it is associated with ovarian endometriosis (OE) 2,4 , 6–11 but other entities as pelvic inflammatory disease, 5–7,9 intrauterine contraceptive device 8,9 and radiotherapy 1 have also been related with the development of PXS. The pathogenesis of PXS is not clear, although different ways have been proposed to explain the histiocytic infiltrate in tubarian plicae 4–10 . The aim of this study is to describe two new cases of PXS in patients with OE.…”