Vasitis nodosa

Vasitis nodosa
	External resources
EHVSC	10185

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

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.

General

Classically seen in a specimen from a 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.
+/-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]).

Images

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

Features:^[4]

PSA -ve.
CK7 +ve
CK34betaE12 +ve.
Vimentin +ve.
CK19 +ve.

Others:

PSAP -ve.

Sign out

Right Vas Deferens, Excision:
     - Vasitis nodosa.

Block letters

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.

Micro

The sections show one unremarkable cross section of the vas deferens and several sections with a histocytic response at the external aspect of the vas deferens' muscle layers. The histocytes are aggregated and contains bland tubular structures with sperm.

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.
↑ Sakaki, M.; Hirokawa, M.; Horiguchi, H.; Wakatsuki, S.; Sano, T. (Apr 2000). "Vasitis nodosa: immunohistochemical findings--case report.". APMIS 108 (4): 283-6. PMID 10843416.

[pmid3366928-1] 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/.

[pmid3984936-2] Balogh, K.; Travis, WD. (Apr 1985). "Benign vascular invasion in vasitis nodosa.". Am J Clin Pathol 83 (4): 426-30. PMID 3984936.

[3] URL: http://medical-dictionary.thefreedictionary.com/elastosis. Accessed on: 26 September 2011.

[pmid10843416-4] Sakaki, M.; Hirokawa, M.; Horiguchi, H.; Wakatsuki, S.; Sano, T. (Apr 2000). "Vasitis nodosa: immunohistochemical findings--case report.". APMIS 108 (4): 283-6. PMID 10843416.

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Vasitis nodosa

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