Vas deferens
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 seldom arrive alone.
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.
Note:
- The words cross section imply the cut is perpendicular to the axis. Thus, the word loop is preferred.
Vasitis nodosa
General
- Classically develops post-vasovasostomy (vasectomy reversal).[4]
- Seen in association with other surgical procedures.
- May be seen in the context of infertility (without prior vasectomy).
- Some similarity to salpingitis isthmica nodosa.[4]
Gross
- Mass.
Microscopic
Features:[4]
- 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.
- Lined by columnar/cuboidal epithelium.
- +/-Sperm granulomas.
- Histocytes - abundant foamy cytoplasm.
- Sperm - small, dark staining, teardrop-shaped (~1 micrometer).
DDx:
- Metastatic (prostate) carcinoma.
Notes:
- Can be confused with prostatic adenocarcinoma:[5]
- May "invade" vascular spaces - associated with elastosis (breakdown of elastic fibres[6]).
Image:
IHC
- PSA -ve.
- PSAP -ve.
Bilateral absence of the vas deferens
- Seen in cystic fibrosis.
See also
References
- ↑ URL: http://www.upmccancercenters.com/cancer/prostate/radprostretropubic.html. Accessed on: 26 September 2011.
- ↑ 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.
- ↑ 3.0 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.
- ↑ 4.0 4.1 4.2 Hirschowitz, L.; Rode, J.; Guillebaud, J.; Bounds, W.; Moss, E. (Apr 1988). "Vasitis nodosa and associated clinical findings.". J Clin Pathol 41 (4): 419-23. PMC 1141468. PMID 3366928. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1141468/.
- ↑ Balogh, K.; Travis, WD. (Apr 1985). "Benign vascular invasion in vasitis nodosa.". Am J Clin Pathol 83 (4): 426-30. PMID 3984936.
- ↑ URL: http://medical-dictionary.thefreedictionary.com/elastosis. Accessed on: 26 September 2011.