International Journal For Multidisciplinary Research

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Incidental Walthard Cell Nests in the Fallopian Tube: A Clinicopathologic Review and Diagnostic Approach

Author(s) Dr. Jayashree - Krishnamurthy, Dr. Chathura - K.R, Dr. Manjunatha - B.S, Dr. Kantharaju - K.H, Dr. Arif - N.K
Country India
Abstract Walthard cell nests (WCNs) are benign transitional/urothelial-type epithelial rests often found incidentally in the fallopian tubes, ovarian hilum, or mesosalpinx. Their recognition is crucial to avoid misdiagnosis as malignant lesions such as serous tubal intraepithelial carcinoma (STIC) or metastasis. We reviewed published literature, including a large retrospective series and case reports, highlighting the incidence, morphology, immunoprofile, and differential diagnosis of WCNs. Additionally, we describe an incidental finding of WCNs encountered during a routine histopathological examination of fallopian tubes. It has been seen that in large series using the Sectioning and Extensively Examining of the FIMbriated End (SEE-FIM) protocol, WCNs are infrequently seen (about 1% of tubes). They appear as small subserosal nests or cysts composed of bland polygonal to cuboidal cells with occasional umbrella cells. They are immunopositive for CK7, GATA3, and p63, and negative for CK20, WT-1, ER, and neuroendocrine markers. Recognition of these features and correlation with clinical history can reliably distinguish WCNs from STIC, neuroendocrine tumors, or metastatic carcinoma. In conclusion WCNs are benign incidental lesions with no clinical consequence, but their accurate identification is essential to prevent overdiagnosis. A focused diagnostic algorithm integrating morphology, SEE-FIM sampling, and a concise immunohistochemical panel can resolve most diagnostic dilemmas.
Keywords Walthard cell nests, fallopian tube, incidental finding, differential diagnosis, histopathology
Field Medical / Pharmacy
Published In Volume 7, Issue 6, November-December 2025
Published On 2025-11-03
DOI https://doi.org/10.36948/ijfmr.2025.v07i06.58779
Short DOI https://doi.org/g99p6j
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