Vas deferens: Difference between revisions

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The '''vas deferens''' is not seen commonly.
[[Image:Normal_Vas_Deferens%2C_Human_%283952564123%29.jpg|thumb|right|Vas deferens. (WC/Ed Uthman)]]
The '''vas deferens''' (plural: vasa deferentia) 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.  


==Vasitis nodosa==
They often arrive alone -- removed for family planning ([[vasectomy]]), where the job of the pathologist is to confirm a full transverse section.
 
==Normal vas deferens==
:''Vasectomy'' redirects here.
===General===
===General===
*Develops post-vasovasostomy.<ref name=pmid3366928>{{Cite journal  | last1 = Hirschowitz | first1 = L. | last2 = Rode | first2 = J. | last3 = Guillebaud | first3 = J. | last4 = Bounds | first4 = W. | last5 = Moss | first5 = E. | title = Vasitis nodosa and associated clinical findings. | journal = J Clin Pathol | volume = 41 | issue = 4 | pages = 419-23 | month = Apr | year = 1988 | doi = | PMID = 3366928 | PMC=1141468 }}</ref>
*Seen in the context of ''vasectomy''.
*Some similarity to [[salpingitis isthmica nodosa]].
 
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===
===Gross===
*Mass.
*Cylindrical piece of tissue.


Note:
*Surface should be inked.
===Microscopic===
===Microscopic===
Features:
Features:<ref name=pmid19926581/>
*Tubules in wall of vas deferens.
*Tubular structure - three muscle layers.
**Lined by columnar/cuboidal epithelium.
**Inner longitudinal (thin).
***May have mitotic activity.
**Middle circular (thick).
***Nucleoli.
**Outer longitudinal (thick).
*+/-Sperm granulomas.
*Epithelium
**Histocytes - abundant foamy cytoplasm.
**Apical cells = columnar, ciliated.
**Sperm - small black dots (~1 micrometer).
**Basal cells = cuboidal.
 
Note:
*Muscle layers - like in bowel.
*A complete loop of epithelium should be visualized in the plane of section.
 
DDx:
*Missed vas deferens.
**Intermediate size blood vessels +/- denudation.
**Ureter.
*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.
*PAX-8 +ve (100%).<ref name=pmid32633248>{{cite journal |authors=Ortiz-Rey JA, Domínguez-de Dios J, Pérez-Schoch M, San Miguel-Fraile P, Gómez-de María C |title=[New immunohistochemistry markers to determine presence of vas deferens in vasectomy specimen.] |language=Spanish; Castilian |journal=Arch Esp Urol |volume=73 |issue=6 |pages=534–540 |date=July 2020 |pmid=32633248 |doi= |url=}}</ref>
*GATA-3 +ve.<ref name=pmid33012491>{{cite journal |authors=Ortiz-Rey JA, Domínguez-de Dios J, Pérez-Schoch M, San Miguel-Fraile P, Gómez-de María C |title=[E-Cadherine and GATA-3 are useful in the confirmation of the vas deferens in vasectomy specimens] |language=Spanish; Castilian |journal=Rev Esp Patol |volume=53 |issue=4 |pages=218–225 |date=2020 |pmid=33012491 |doi=10.1016/j.patol.2020.02.005 |url=}}</ref>
*ERG -ve.<ref name=pmid32633248/>
*CD34 -ve.<ref name=pmid32633248/>
 
===Sign out===
====Right then left====
<pre>
A. VAS DEFERENS, RIGHT, VASECTOMY:
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOP OF EPITHELIUM AND MUSCLE LAYERS PRESENT.
 
B. VAS DEFERENS, LEFT, VASECTOMY:
- 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>
 
<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>
 
====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:
*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==
*Seen in [[cystic fibrosis]].


==See also==
==See also==
*[[Ditzels]].
*[[Ditzels]].
*[[Genitourinary pathology]].
*[[Genitourinary pathology]].
*[[Prostate gland]].
*[[Testis]].
*[[Male infertility]].
*[[Epididymis]].


==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Genitourinary pathology]]
[[Category:Genitourinary pathology]]
Retrieved from "https://librepathology.org/wiki/Vas_deferens"