Inflammatory etiology of salpingitis isthmica nodosa: a clinical, histological and ultrastructural study

Fifteen patients with obstructive salpingitis isthmica nodosa were studied. Histologically the tubal lumen was narrowed in all cases and in five patients the central tubal lumen could not be detected at all. In all cases an at least slight inflammatory response was found, consisting of lymphocytes and slight fibrosis. Seven of the patients had high serum chlamydial antibody titers (greater than 128). Ultrastructurally the epithelium lining the gland-like structure was similar to normal tubal epithelium. Inflammation may be a chronic irritant, leading to tubal spasm, muscular hypertrophy and eventually to salpingitis isthmica nodosa.