Vas deferens

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The vas deferens are often seen as part of a prostatectomy specimen.[1] They seldom arrive alone.

Vasitis nodosa

General

  • Classically develops post-vasovasostomy (vasectomy reversal).[2]
    • Seen in association with other surgical procedures.
    • May be seen in the context of infertility (without prior vasectomy).
  • Some similarity to salpingitis isthmica nodosa.[2]

Gross

  • Mass.

Microscopic

Features:[2]

  • 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:[3]
    • May "invade" vascular spaces - associated with elastosis (breakdown of elastic fibres[4]).

Image:

IHC

  • PSA -ve.
  • PSAP -ve.

See also

References

  1. URL: http://www.upmccancercenters.com/cancer/prostate/radprostretropubic.html. Accessed on: 26 September 2011.
  2. 2.0 2.1 2.2 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/.
  3. Balogh, K.; Travis, WD. (Apr 1985). "Benign vascular invasion in vasitis nodosa.". Am J Clin Pathol 83 (4): 426-30. PMID 3984936.
  4. URL: http://medical-dictionary.thefreedictionary.com/elastosis. Accessed on: 26 September 2011.