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Endosalpingiosis, a term referring to tuballike epithelium in aberrant sites has been reported infrequently.1–7 When associated with endometriosis, endosalpingiosis has been regarded as a metaplastic process.6 These cases are said to be rare8 and are an uncommon cause for psammoma bodies in cul-de-sac fluid. In any patient with psammoma bodies in cul-de-sac fluid, a primary epithelial neoplasm must be excluded. This is a report of a case of endosalpingiosis and psammoma bodies in cul-de-sac fluid, its diagnosis, and possible pathogenesis.

Case report

A 40-year-old gravida I, para 0 white woman was admitted to the Cleveland Clinic Hospital for elective sterilization. Because of a history of endometriosis, pre-menstrual tension symptoms, and dysmenorrhea, total abdominal hysterectomy and salpingo-oophorectomy was performed. Medical history included remote use of oral contraceptives. Fourteen years earlier she had partial resections of both ovaries and right salpingectomy. Review of the microscopic sections revealed chronic active salpingo-oophoritis involving the right tube and both ovaries. Endometriosis involved both ovaries and the right ovary also contained a dermoid cyst.

Results of the initial physical examination revealed third-degree retroposition of the uterus. External genitalia, vagina, and cervix were unremarkable. No abnormal adnexal masses were palpated. A hysterectomy and left salpingo-oophorectomy, partial right salpingectomy, and right oophorectomy were performed. In addition to implants of endometriosis, the surgeon described several small cystic lesions over the uterine serosa and pelvic peritoneum; cul-de-sac fluid was obtained for cytologic study at the time of surgery.

Pathologic findings

The specimen consisted of uterus, left fallopian tube, portion . . .



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