Vas deferens

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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:

  • Tubular structure - two muscle layers.
    • Inner circular.
    • Outer longitudinal.
  • Epithelium = simple, columnar, ciliated.

Note:

  • Muscle layers - like in bowel.
  • Lumen must be completely 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.

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Right then left

A. VAS DEFERENS, RIGHT, VASECTOMY:
- VAS DEFERENS WITHIN NORMAL LIMITS, COMPLETE CROSS SECTION PRESENT.

B. VAS DEFERENS, LEFT, VASECTOMY:
- VAS DEFERENS WITHIN NORMAL LIMITS, COMPLETE CROSS SECTION PRESENT.

Left then right

A. VAS DEFERENS, LEFT, VASECTOMY:
- VAS DEFERENS WITHIN NORMAL LIMITS.

B. VAS DEFERENS, RIGHT, VASECTOMY:
- VAS DEFERENS WITHIN NORMAL LIMITS.

Single container

VAS DEFERENS, RIGHT AND LEFT, VASECTOMY:
- VAS DEFERENS WITHIN NORMAL LIMITS.

Incomplete cross-section

A. VAS DEFERENS, RIGHT, VASECTOMY:
- INCOMPLETE CROSS-SECTION OF VAS DEFERENS WITHOUT SIGNIFICANT PATHOLOGY, SEE COMMENT.

B. VAS DEFERENS, LEFT, VASECTOMY:
- VAS DEFERENS WITHIN NORMAL LIMITS.

COMMENT:
The epithelium lining the vas deferens is at the edge of the tissue fragment and has
crush/thermal artefact. It is not possible to determine if the epithelial lining
is complete. Clinical correlation is suggested.
/pre>

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. *+/-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: *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.

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. 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. 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/.
  5. Balogh, K.; Travis, WD. (Apr 1985). "Benign vascular invasion in vasitis nodosa.". Am J Clin Pathol 83 (4): 426-30. PMID 3984936.
  6. URL: http://medical-dictionary.thefreedictionary.com/elastosis. Accessed on: 26 September 2011.