Prolapsed fallopian tube: cytological findings in a ThinPrep liquid based cytology vaginal vault sample

Fallopian tube prolapse through the vaginal vault after hysterectomy is a rare complication. The clinical diagnosis is difficult and the patient may undergo unnecessary treatment. A cytological diagnosis of tubal prolapse is rare. There are very few descriptions of the cytological appearances of prolapsed fallopian tube and to our knowledge, they have not been described in liquid based cytology preparations. The presence of classic columnar cells with cilia and sheets of cells with small granular uniform nuclei in an orderly arrangement are the diagnostic appearances of cells originating from the fallopian tube. We describe a case in which the cells had undergone squamous metaplasia with nuclear enlargement and increased nuclear to cytoplasmic ratios corresponding to reactive atypia but with fine and evenly distributed chromatin and smooth nuclear contours, which indicated their benign nature. In addition, in this case intracytoplasmic polymorphs and associated extracellular infiltrates of inflammatory cells are noted. The description of this case may help others to consider a cytological diagnosis of prolapsed fallopian tube, thus preventing repeated cauterisations of vault granulation tissue on one hand, and possibly excessive surgical treatment of a mistaken malignant lesion on the other.