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:Cite error: Closing </ref> missing for <ref> tag

  • 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, COMPLETE CROSS SECTION PRESENT.

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

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, COMPLETE CROSS SECTION PRESENT.

COMMENT:
Clinical correlation is suggested.

Vasitis nodosa

General

  • Classically develops post-vasovasostomy (vasectomy reversal).[3]
    • Seen in association with other surgical procedures.
    • May be seen in the context of infertility (without prior vasectomy).
  • Some similarity to salpingitis isthmica nodosa.[3]

Gross

  • Mass.

Microscopic

Features:[3]

  • 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:

Image:

IHC

  • PSA -ve.
  • PSAP -ve.

Bilateral absence of the vas deferens

See also

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. 3.0 3.1 3.2 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/.
  4. Balogh, K.; Travis, WD. (Apr 1985). "Benign vascular invasion in vasitis nodosa.". Am J Clin Pathol 83 (4): 426-30. PMID 3984936.
  5. URL: http://medical-dictionary.thefreedictionary.com/elastosis. Accessed on: 26 September 2011.