Vasitis nodosa
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Vasitis nodosa, abbreviated VN, is a common complication of vasectomy that is seldomly seen by pathologists. It is seen by pathologists in the context of vasovasostomy.
| Vasitis nodosa | |
|---|---|
| Diagnosis in short | |
 Vasitis nodosa (left side of image). H&E stain. | |
|
| |
| LM | tubules with sperm |
| LM DDx | prostate carcinoma, metastatic adenocarcinoma |
| IHC | PSA -ve, PSAP -ve |
| Site | vas deferens |
|
| |
| Clinical history | (usually) previous vasectomy |
| Prognosis | benign |
General
- Classically develops post-vasovasostomy (vasectomy reversal).[1]
- Seen in association with other surgical procedures.
- May be seen in the context of infertility (without prior vasectomy).
- Some similarity to salpingitis isthmica nodosa.[1]
Gross
- Mass.
Microscopic
Features:[1]
- 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.
- Lined by columnar/cuboidal epithelium.
- +/-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:[2]
- May "invade" vascular spaces - associated with elastosis (breakdown of elastic fibres[3]).
Image
VN - intermed. mag. (WC)
VN - intermed. mag. (WC)
VN - high mag. (WC)
VN - high mag. (WC)
VN - very high mag. (WC)
VN - high mag. (WC)
VN - Very high mag. (WC)
www:
IHC
- PSA -ve.
- PSAP -ve.
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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.
See also
References
- ↑ 1.0 1.1 1.2 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.