Vas deferens

The vas deferens are often seen as part of a prostatectomy specimen. 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.

Gross

• Cylindrical piece of tissue.

Note:

• Surface should be inked.

Microscopic

Features:

• 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:

• 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

General

• Classically develops post-vasovasostomy (vasectomy reversal).
  • Seen in association with other surgical procedures.
  • May be seen in the context of infertility (without prior vasectomy).
• Some similarity to salpingitis isthmica nodosa.

Gross

• Mass.

Microscopic

Features:

• 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.
• +/-Sperm granulomas.
  • 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:
  • May "invade" vascular spaces - associated with elastosis (breakdown of elastic fibres).

Image:

• Vasitis nodosa (webpathology.com).

IHC

• PSA -ve.
• PSAP -ve.

Bilateral absence of the vas deferens

• Seen in cystic fibrosis.

See also

• Ditzels.
• Genitourinary pathology.
• Prostate gland.
• Testis.