Vasitis nodosa

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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.

Vasitis nodosa
Diagnosis in short

Vasitis nodosa (left side of image). H&E stain.

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

Clinical history (usually) previous vasectomy
Prognosis benign

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.

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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

  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.