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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Vasitis nodosa -11- intermed mag.jpg | |||
| Width = | |||
| Caption = Vasitis nodosa (left side of image). [[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 = (usually) previous [[vasectomy]] | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = | |||
}} | |||
{{ Infobox external links | |||
| Name = {{PAGENAME}} | |||
| EHVSC = 10185 | |||
| pathprotocols = | |||
| wikipedia = | |||
| pathoutlines = | |||
}} | |||
'''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 seen in a specimen from a 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>). | |||
===Images=== | |||
<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)]. | |||
*[http://www.flickr.com/photos/lunarcaustic/6938362234/ Vasitis nodosa (flickr.com/lunar caustic)]. | |||
==IHC== | |||
Features:<ref name=pmid10843416>{{Cite journal | last1 = Sakaki | first1 = M. | last2 = Hirokawa | first2 = M. | last3 = Horiguchi | first3 = H. | last4 = Wakatsuki | first4 = S. | last5 = Sano | first5 = T. | title = Vasitis nodosa: immunohistochemical findings--case report. | journal = APMIS | volume = 108 | issue = 4 | pages = 283-6 | month = Apr | year = 2000 | doi = | PMID = 10843416 }} | |||
</ref> | |||
*[[PSA]] -ve. | |||
*[[CK7]] +ve | |||
*[[CK34betaE12]] +ve. | |||
*Vimentin +ve. | |||
*CK19 +ve. | |||
Others: | |||
*[[PSAP]] -ve. | |||
==Sign out== | |||
<pre> | |||
Right Vas Deferens, Excision: | |||
- Vasitis nodosa. | |||
</pre> | |||
===Block letters=== | |||
<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> | |||
===Micro=== | |||
The sections show one unremarkable cross section of the vas deferens and several sections with a histocytic response at the external aspect of the vas deferens' muscle layers. The histocytes are aggregated and contains bland tubular structures with sperm. | |||
The tubular structures are POSITIVE for CK7 and CK34betaE12, and NEGATIVE for PSA. CD68 marks the histiocytes. | |||
==See also== | |||
*[[Vas deferens]]. | |||
*[[Genitourinary pathology]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Genitourinary pathology]] | |||
[[Category:Diagnosis]] | |||