Difference between revisions of "Vasitis nodosa"

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#redirect [[Vas_deferens#Vasitis_nodosa]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      =  Vasitis nodosa -11- intermed mag.jpg
| Width      =
| Caption    = Vasitis nodosa. [[H&E stain]].
| Micro      = tubules with sperm
| Subtypes  =
| LMDDx      = [[prostate carcinoma]], metastatic [[adenocarcinoma]]
| Stains    =
| IHC        = PSA -ve, PSAP -ve
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[vas deferens]]
| Assdx      =
| Syndromes  =
| Clinicalhx = previous [[vasectomy]]
| Signs      =
| Symptoms  =
| Prevalence =
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
}}
'''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 develops post-vasovasostomy ([[vasectomy]] reversal).<ref name=pmid3366928>{{Cite journal  | last1 = Hirschowitz | first1 = L. | last2 = Rode | first2 = J. | last3 = Guillebaud | first3 = J. | last4 = Bounds | first4 = W. | last5 = Moss | first5 = E. | title = Vasitis nodosa and associated clinical findings. | journal = J Clin Pathol | volume = 41 | issue = 4 | pages = 419-23 | month = Apr | year = 1988 | doi =  | PMID = 3366928 | PMC=1141468 }}</ref>
**Seen in association with other surgical procedures.
**May be seen in the context of infertility (without prior vasectomy).
*Some similarity to [[salpingitis isthmica nodosa]].<ref name=pmid3366928/>
==Gross==
*Mass.
==Microscopic==
Features:<ref name=pmid3366928/>
*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 granuloma]]s.
**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]]:<ref name=pmid3984936>{{Cite journal  | last1 = Balogh | first1 = K. | last2 = Travis | first2 = WD. | title = Benign vascular invasion in vasitis nodosa. | journal = Am J Clin Pathol | volume = 83 | issue = 4 | pages = 426-30 | month = Apr | year = 1985 | doi =  | PMID = 3984936 }}</ref>
**May "invade" vascular spaces - associated with elastosis (breakdown of elastic fibres<ref>URL: [http://medical-dictionary.thefreedictionary.com/elastosis http://medical-dictionary.thefreedictionary.com/elastosis]. Accessed on: 26 September 2011.</ref>).
===Image===
<gallery>
Image: Vasitis nodosa -11- intermed mag.jpg | VN - intermed. mag. (WC)
Image: Vasitis nodosa -12- intermed mag.jpg | VN - intermed. mag. (WC)
Image: Vasitis nodosa -11- high mag.jpg | VN - high mag. (WC)
Image: Vasitis nodosa -12- high mag.jpg | VN - high mag. (WC)
Image: Vasitis nodosa -11- very high mag.jpg | VN - very high mag. (WC)
</gallery>
<gallery>
Image: Vasitis nodosa -21- high mag.jpg | VN - high mag. (WC)
Image: Vasitis nodosa -21- very high mag.jpg | VN - Very high mag. (WC)
</gallery>
www:
*[http://www.webpathology.com/image.asp?n=11&Case=40 Vasitis nodosa (webpathology.com)].
==IHC==
*PSA -ve.
*PSAP -ve.
==Sign out==
<pre>
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.
</pre>
==See also==
*[[Vas deferens]].
*[[Genitourinary pathology]].
==References==
{{Reflist|2}]
[[Category:Genitourinary pathology]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Revision as of 21:10, 20 July 2013

Vasitis nodosa
Diagnosis in short

Vasitis nodosa. H&E stain.

LM tubules with sperm
LM DDx prostate carcinoma, metastatic adenocarcinoma
IHC PSA -ve, PSAP -ve
Site vas deferens

Clinical history 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 develops post-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:

Notes:

Image

www:

IHC

  • PSA -ve.
  • PSAP -ve.

Sign out

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.

See also

References

{{Reflist|2}]

  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/.
  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.