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:
- 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.
Sign out
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
- ↑ 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.
- ↑ 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.