48,584
edits
(40 intermediate revisions by the same user not shown) | |||
Line 1: | Line 1: | ||
The '''vas deferens''' are often seen as part of a [[prostate gland|prostatectomy]] specimen.<ref>URL: [http://www.upmccancercenters.com/cancer/prostate/radprostretropubic.html http://www.upmccancercenters.com/cancer/prostate/radprostretropubic.html]. Accessed on: 26 September 2011.</ref> They are the component of the [[spermatic cord]] that carries the sperm. They | The '''vas deferens''' are often seen as part of a [[prostate gland|prostatectomy]] specimen.<ref>URL: [http://www.upmccancercenters.com/cancer/prostate/radprostretropubic.html http://www.upmccancercenters.com/cancer/prostate/radprostretropubic.html]. Accessed on: 26 September 2011.</ref> They are the component of the [[spermatic cord]] that carries the sperm. | ||
They often arrive alone -- removed for family planning ([[vasectomy]]). | |||
==Normal vas deferens== | ==Normal vas deferens== | ||
Line 6: | Line 8: | ||
*Seen in the context of ''vasectomy''. | *Seen in the context of ''vasectomy''. | ||
Note: | |||
*Vasectomy is associated with [[testicle|testicular changes]] - increased seminiferous tubule wall thickness and decreased number of Sertoli cells.<ref name=pmid4058505>{{Cite journal | last1 = Jarow | first1 = JP. | last2 = Budin | first2 = RE. | last3 = Dym | first3 = M. | last4 = Zirkin | first4 = BR. | last5 = Noren | first5 = S. | last6 = Marshall | first6 = FF. | title = Quantitative pathologic changes in the human testis after vasectomy. A controlled study. | journal = N Engl J Med | volume = 313 | issue = 20 | pages = 1252-6 | month = Nov | year = 1985 | doi = 10.1056/NEJM198511143132003 | PMID = 4058505 }}</ref> | |||
===Gross=== | |||
*Cylindrical piece of tissue. | |||
Note: | |||
*Surface should be inked. | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features:<ref name=pmid19926581/> | ||
*Tubular structure - | *Tubular structure - three muscle layers. | ||
*Epithelium = | **Inner longitudinal (thin). | ||
**Middle circular (thick). | |||
**Outer longitudinal (thick). | |||
*Epithelium | |||
**Apical cells = columnar, ciliated. | |||
**Basal cells = cuboidal. | |||
Note: | |||
*Muscle layers - like in bowel. | |||
*A complete loop of epithelium should be visualized in the plane of section. | |||
DDx: | DDx: | ||
*Missed vas deferens. | *Missed vas deferens. | ||
*Incomplete vasectomy - only partial lumen. | |||
===IHC=== | |||
Features:<ref name=pmid19926581>{{Cite journal | last1 = Sasaki | first1 = K. | last2 = Bastacky | first2 = SI. | last3 = Zynger | first3 = DL. | last4 = Parwani | first4 = AV. | title = Use of immunohistochemical markers to confirm the presence of vas deferens in vasectomy specimens. | journal = Am J Clin Pathol | volume = 132 | issue = 6 | pages = 893-8 | month = Dec | year = 2009 | doi = 10.1309/AJCPQZX4WS8UPKGG | PMID = 19926581 }} | |||
</ref> | |||
*CD10 +ve (marker of Wolffian differentiation). | |||
*Pankeratin +ve. | |||
===Sign out=== | ===Sign out=== | ||
====Right then left==== | |||
<pre> | <pre> | ||
A. VAS DEFERENS, RIGHT, VASECTOMY: | A. VAS DEFERENS, RIGHT, VASECTOMY: | ||
- VAS DEFERENS WITHIN NORMAL LIMITS. | - VAS DEFERENS WITHIN NORMAL LIMITS, LOOP OF EPITHELIUM AND MUSCLE LAYERS PRESENT. | ||
B. VAS DEFERENS, LEFT, VASECTOMY: | B. VAS DEFERENS, LEFT, VASECTOMY: | ||
- VAS DEFERENS WITHIN NORMAL LIMITS. | - VAS DEFERENS WITHIN NORMAL LIMITS, LOOP OF EPITHELIUM AND MUSCLE LAYERS PRESENT. | ||
</pre> | |||
====Left then right==== | |||
<pre> | |||
A. VAS DEFERENS, LEFT, VASECTOMY: | |||
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOP OF EPITHELIUM AND MUSCLE LAYERS PRESENT. | |||
B. VAS DEFERENS, RIGHT, VASECTOMY: | |||
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOP OF EPITHELIUM AND MUSCLE LAYERS PRESENT. | |||
</pre> | |||
====Single container==== | |||
<pre> | |||
VAS DEFERENS, RIGHT AND LEFT, VASECTOMY: | |||
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOPS OF EPITHELIUM AND MUSCLE LAYERS PRESENT. | |||
</pre> | |||
=====Alternate===== | |||
<pre> | |||
VAS DEFERENS, RIGHT AND LEFT, VASECTOMY: | |||
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOPS OF EPITHELIUM AND MUSCLE LAYERS PRESENT | |||
ON BOTH SLIDE A1-1 AND SLIDE A2-1. | |||
</pre> | |||
=====One container is empty===== | |||
<pre> | |||
A. VAS DEFERENS ("LEFT"), VASECTOMY: | |||
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOPS OF EPITHELIUM AND MUSCLE LAYERS PRESENT | |||
ON BOTH SLIDE A1-1 AND SLIDE A2-1. | |||
- SEE COMMENT. | |||
B. VAS DEFERENS ("RIGHT"), VASECTOMY: | |||
- NO TISSUE IDENTIFIED, SEE COMMENT. | |||
COMMENT: | |||
Both specimens (left vas deferens and right vas deferens) may have been placed in | |||
container A. See 'gross' section of report. Clinical correlation is essential. | |||
</pre> | </pre> | ||
== | ====Incomplete loop==== | ||
=== | <pre> | ||
A. VAS DEFERENS, RIGHT, VASECTOMY: | |||
- VAS DEFERENS WITHOUT SIGNIFICANT PATHOLOGY - INCOMPLETE LOOP OF EPITHELIUM, SEE COMMENT. | |||
B. VAS DEFERENS, LEFT, VASECTOMY: | |||
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOP OF EPITHELIUM AND MUSCLE LAYERS PRESENT. | |||
COMMENT: | |||
Clinical correlation is suggested. | |||
</pre> | |||
=== | ====Oblique cut==== | ||
<pre> | |||
A. VAS DEFERENS, RIGHT, VASECTOMY: | |||
- VAS DEFERENS WITHOUT SIGNIFICANT PATHOLOGY - OBLIQUE SECTION WITH COMPRESSED | |||
LOOP OF EPITHELIUM, SEE COMMENT. | |||
B. VAS DEFERENS, LEFT, VASECTOMY: | |||
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOP OF EPITHELIUM AND MUSCLE LAYERS PRESENT. | |||
COMMENT: | |||
Clinical correlation is suggested. | |||
</pre> | |||
Notes: | Notes: | ||
* | *The word ''loop'' is preferred over the words ''cross section'' as: | ||
*#The words ''cross section'' imply the cut is perpendicular to the axis. | |||
*#It is possible that a section with a loop of epithelium is the result of a non-transecting cut that generates an ovoid defect in the wall of the vas deferens. | |||
====No definite epithelium==== | |||
<pre> | |||
A. VAS DEFERENS, LEFT, VASECTOMY: | |||
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOP OF EPITHELIUM AND MUSCLE LAYERS PRESENT. | |||
B. VAS DEFERENS, RIGHT, VASECTOMY: | |||
- COMPATIBLE WITH VAS DEFERENS, WITHOUT COMPLETE LOOP OF EPITHELIUM, SEE COMMENT. | |||
COMMENT - PART B: | |||
Definite vas deferens epithelium is not identified; however, the muscle layering seen is | |||
compatible with a vas deferens. Levels were cut (x4). | |||
Clinical correlation is suggested. | |||
</pre> | |||
====No vas deferens identified==== | |||
<pre> | |||
A. CONNECTIVE TISSUE, RIGHT, "VASECTOMY": | |||
- NO VAS DEFERENS IDENTIFIED. | |||
- BENIGN FIBROMUSCULAR TISSUE WITH INTERMEDIATE BLOOD VESSELS. | |||
B. CONNECTIVE TISSUE, LEFT, "VASECTOMY": | |||
- NO VAS DEFERENS IDENTIFIED. | |||
- BENIGN FIBROMUSCULAR TISSUE WITH INTERMEDIATE BLOOD VESSELS. | |||
COMMENT: | |||
Levels were cut (x3). Clinical correlation is suggested. | |||
</pre> | |||
=== | ==Vasitis nodosa== | ||
{{Main|Vasitis nodosa}} | |||
==Bilateral absence of the vas deferens== | ==Bilateral absence of the vas deferens== | ||
Line 66: | Line 156: | ||
*[[Prostate gland]]. | *[[Prostate gland]]. | ||
*[[Testis]]. | *[[Testis]]. | ||
*[[Male infertility]]. | |||
*[[Epididymis]]. | |||
==References== | ==References== |
edits