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Histology · Additional topics

Histology of the uterine appendages

Tuba uterina, salpinx

The uterine appendages include the uterine tubes, which develop from the paramesonephric ducts. Their histological structure ensures oocyte transport and fertilization, while pathological changes include ectopic pregnancy and trophoblastic tumors.

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TopographyIntraperitoneal position along the upper edge of the ligament
Embryonic remnantsMüllerian duct derivatives and mesonephric rudiments
Ectopic conditionChorionic villi penetrate the muscular layer of the tube
hCG markerBeta-hCG levels exceed 150,000 IU/L in hydatidiform mole
2 min readFor medical studentsUpdated 10.10.2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesPending instructor review

Topography and anatomical relations of the uterine tubes

The uterine tube (tuba uterina, salpinx) lies intraperitoneally along the superior margin of the broad ligament of the uterus (lig. latum uteri). The edge of this ligament extending toward the pelvic wall forms the suspensory ligament of the ovary.

The syntopy of the organ has the following features:

  • Medially: the uterine part of the tube penetrates the thickness of the uterine wall.
  • Laterally: the infundibulum with fimbriae is located near the ovary to capture the oocyte.
  • Posteroinferior wall: forms the upper boundary of the rectouterine pouch (pouch of Douglas) — the deepest recess of the peritoneal cavity.

Development of the female genital tract and embryonic rudiments

During embryogenesis, the female reproductive system develops from the paramesonephric or Müllerian ducts, which differentiate into the uterine tubes, uterus, and upper vagina. The pronephros/mesonephros (mesonephros) and the Wolffian duct undergo regression, but their remnants are important for histology:

  1. Remnants of the pronephros give rise to the appendages of the ovary (epoophoron and paraophoron).
  2. A segment of the Wolffian duct persists as Gartner's duct.
Test your knowledge on the topicTasks from the Histology course bank — instant answers and explanations.

Morphology of tubal pregnancy

In ectopic localization of the ovum, the uterine tube expands in a specific segment. Microscopic examination reveals:

  • Extensive hemorrhages and accumulations of trophoblast cells in the tubal wall.
  • Chorionic villi invading the muscular layer of the organ.
  • Presence of extravillous trophoblast and fibrinoid with a weakly expressed decidual reaction.

Termination of tubal pregnancy occurs via tubal abortion or rupture of the tubal wall, accompanied by massive internal hemorrhage and an acute abdomen clinical presentation.

Trophoblastic disease: hydatidiform mole and choriocarcinoma

Trophoblastic pathology includes benign and malignant processes:

  • Hydatidiform mole: chorionic villi are cystically altered, resembling bunches of grapes. Characterized by marked stromal edema with cistern formation, avascularity of the villi, and pronounced epithelial proliferation.
  • Choriocarcinoma: a malignant tumor composed of syncytio- and cytotrophoblast elements. Microscopy reveals sheets of monomorphic clear cytotrophoblast cells surrounded by multinucleated syncytiotrophoblast, with foci of necrosis and early hematogenous metastasis.
How to memorize

The Müllerian duct forms the tubes and uterus, while the Wolffian duct leaves behind traces — Gartner's duct and the epoophoron.

Class and exam questions

What are the main microscopic features of tubal pregnancy?

The wall of the uterine tube reveals chorionic villi penetrating the muscular layer, trophoblast cells, fibrinoid, and extensive hemorrhages with a weak decidual reaction.

What mesonephric system remnants persist in women?

Remnants of the primitive kidney persist, forming the epoophoron (epoophoron) and paraophoron (paraophoron), as well as a segment of the Wolffian duct in the form of Gartner's duct.

What are the histological features of a hydatidiform mole?

Chorionic villi are markedly edematous, devoid of vessels, form central fluid-filled cisterns, and are accompanied by prominent proliferation of the trophoblastic epithelium.

Which laboratory marker is most informative in gestational trophoblastic disease?

Blood tests show an unusually high level of human chorionic gonadotropin (beta-hCG), exceeding 150,000 IU/L in hydatidiform mole.

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What else to study on this topic

  • Clinical presentation and types of termination of tubal pregnancy
  • Differential diagnosis of ruptured ectopic pregnancy
  • Rare localizations of ectopic pregnancy (abdominal, cervical, ovarian)
  • Histological examination of uterine cavity scrapings in suspected pregnancy pathology
  • Cytological and tissue structure of choriocarcinoma

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