Difference between revisions of "Vas deferens"

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==Vasitis nodosa==
==Vasitis nodosa==
===General===
{{Main|Vasitis nodosa}}
*Classically develops post-vasovasostomy ([[vasectomy]] reversal).<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 association with other surgical procedures.
**May be seen in the context of infertility (without prior vasectomy).
*Some similarity to [[salpingitis isthmica nodosa]].<ref name=pmid3366928/>
 
===Gross===
*Mass.
 
===Microscopic===
Features:<ref name=pmid3366928/>
*Tubules in wall of vas deferens.
**Lined by columnar/cuboidal epithelium.
***May have mitotic activity.
***Nucleoli.
***Contain sperm - small, dark staining, teardrop-shaped (~1 micrometer) - '''key feature'''.
****The tail is rarely seen completely in the plane of section.
*+/-[[Sperm granuloma]]s.
**Histocytes - abundant foamy cytoplasm.
**Sperm - small, dark staining, teardrop-shaped (~1 micrometer).
 
DDx:
*[[Metastatic]] carcinoma, especially [[prostate carcinoma]].
 
Notes:
*Can be confused with [[prostatic adenocarcinoma]]:<ref name=pmid3984936>{{Cite journal  | last1 = Balogh | first1 = K. | last2 = Travis | first2 = WD. | title = Benign vascular invasion in vasitis nodosa. | journal = Am J Clin Pathol | volume = 83 | issue = 4 | pages = 426-30 | month = Apr | year = 1985 | doi =  | PMID = 3984936 }}</ref>
**May "invade" vascular spaces - associated with elastosis (breakdown of elastic fibres<ref>URL: [http://medical-dictionary.thefreedictionary.com/elastosis http://medical-dictionary.thefreedictionary.com/elastosis]. Accessed on: 26 September 2011.</ref>).
 
====Image====
<gallery>
Image: Vasitis nodosa -11- intermed mag.jpg | VN - intermed. mag. (WC)
Image: Vasitis nodosa -12- intermed mag.jpg | VN - intermed. mag. (WC)
Image: Vasitis nodosa -11- high mag.jpg | VN - high mag. (WC)
Image: Vasitis nodosa -12- high mag.jpg | VN - high mag. (WC)
Image: Vasitis nodosa -11- very high mag.jpg | VN - very high mag. (WC)
</gallery>
<gallery>
Image: Vasitis nodosa -21- high mag.jpg | VN - high mag. (WC)
Image: Vasitis nodosa -21- very high mag.jpg | VN - Very high mag. (WC)
</gallery>
www:
*[http://www.webpathology.com/image.asp?n=11&Case=40 Vasitis nodosa (webpathology.com)].
 
===IHC===
*PSA -ve.
*PSAP -ve.
 
===Sign out===
<pre>
A. VAS DEFERENS WITH GRANULOMA, RIGHT, VASOVASOSTOMY:
- VASITIS NODOSA AND SPERM GRANULOMAS.
- COMPLETE CROSS SECTION OF VAS DEFERENS.
 
B. VAS DEFERENS WITH GRANULOMA, LEFT, VASOVASOSTOMY:
- VASITIS NODOSA AND SPERM GRANULOMAS.
- COMPLETE CROSS SECTION OF VAS DEFERENS.
</pre>


==Bilateral absence of the vas deferens==
==Bilateral absence of the vas deferens==

Revision as of 21:07, 20 July 2013

The vas deferens are often seen as part of a prostatectomy specimen.[1] They are the component of the spermatic cord that carries the sperm.

They often arrive alone -- removed for family planning (vasectomy).

Normal vas deferens

Vasectomy redirects here.

General

  • Seen in the context of vasectomy.

Note:

  • Vasectomy is associated with testicular changes - increased seminiferous tubule wall thickness and decreased number of Sertoli cells.[2]

Gross

  • Cylindrical piece of tissue.

Note:

  • Surface should be inked.

Microscopic

Features:[3]

  • Tubular structure - three muscle layers.
    • 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:

  • Missed vas deferens.
  • Incomplete vasectomy - only partial lumen.

IHC

Features:[3]

  • CD10 +ve (marker of Wolffian differentiation).
  • Pankeratin +ve.

Sign out

Right then left

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.

Left then right

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.

Single container

VAS DEFERENS, RIGHT AND LEFT, VASECTOMY:
- VAS DEFERENS WITHIN NORMAL LIMITS, LOOPS OF EPITHELIUM AND MUSCLE LAYERS PRESENT.

Incomplete loop

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.

Oblique cut

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.

Notes:

  • The word loop is preferred over the words cross section as:
    1. The words cross section imply the cut is perpendicular to the axis.
    2. 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.

Vasitis nodosa

Bilateral absence of the vas deferens

See also

References

  1. URL: http://www.upmccancercenters.com/cancer/prostate/radprostretropubic.html. Accessed on: 26 September 2011.
  2. Jarow, JP.; Budin, RE.; Dym, M.; Zirkin, BR.; Noren, S.; Marshall, FF. (Nov 1985). "Quantitative pathologic changes in the human testis after vasectomy. A controlled study.". N Engl J Med 313 (20): 1252-6. doi:10.1056/NEJM198511143132003. PMID 4058505.
  3. 3.0 3.1 Sasaki, K.; Bastacky, SI.; Zynger, DL.; Parwani, AV. (Dec 2009). "Use of immunohistochemical markers to confirm the presence of vas deferens in vasectomy specimens.". Am J Clin Pathol 132 (6): 893-8. doi:10.1309/AJCPQZX4WS8UPKGG. PMID 19926581.