Difference between revisions of "Vas deferens"
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*Seen in the context of ''vasectomy''. | *Seen in the context of ''vasectomy''. | ||
Note: | |||
*Vasectomy is associated with [[testicle|testicular changes]] - increased seminiferous tubule wall thickness and decreased number of Sertoli cells.<ref name=pmid4058505>{{Cite journal | last1 = Jarow | first1 = JP. | last2 = Budin | first2 = RE. | last3 = Dym | first3 = M. | last4 = Zirkin | first4 = BR. | last5 = Noren | first5 = S. | last6 = Marshall | first6 = FF. | title = Quantitative pathologic changes in the human testis after vasectomy. A controlled study. | journal = N Engl J Med | volume = 313 | issue = 20 | pages = 1252-6 | month = Nov | year = 1985 | doi = 10.1056/NEJM198511143132003 | PMID = 4058505 }}</ref> | |||
===Gross=== | |||
*Cylindrical piece of tissue. | |||
Note: | |||
*Surface should be inked. | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
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Note: | Note: | ||
*Muscle layers - like in bowel. | *Muscle layers - like in bowel. | ||
*Lumen must be completely visualized in the plane of section. | |||
DDx: | DDx: | ||
*Missed vas deferens. | *Missed vas deferens. | ||
*Incomplete vasectomy - only partial lumen. | |||
===IHC=== | ===IHC=== | ||
Revision as of 14:12, 27 January 2013
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:
- Tubular structure - two muscle layers.
- Inner circular.
- Outer longitudinal.
- Epithelium = simple, columnar, ciliated.
Note:
- Muscle layers - like in bowel.
- Lumen must be completely visualized in the plane of section.
DDx:
- Missed vas deferens.
- Incomplete vasectomy - only partial lumen.
IHC
Features:[3]
- CD10 +ve (marker of Wolffian differentiation).
- Pankeratin +ve.
Sign out
Right then left
A. VAS DEFERENS, RIGHT, VASECTOMY: - VAS DEFERENS WITHIN NORMAL LIMITS. B. VAS DEFERENS, LEFT, VASECTOMY: - VAS DEFERENS WITHIN NORMAL LIMITS.
Left then right
A. VAS DEFERENS, LEFT, VASECTOMY: - VAS DEFERENS WITHIN NORMAL LIMITS. B. VAS DEFERENS, RIGHT, VASECTOMY: - VAS DEFERENS WITHIN NORMAL LIMITS.
Single container
VAS DEFERENS, RIGHT AND LEFT, VASECTOMY: - VAS DEFERENS WITHIN NORMAL LIMITS.
Vasitis nodosa
General
- Classically develops post-vasovasostomy (vasectomy reversal).[4]
- Seen in association with other surgical procedures.
- May be seen in the context of infertility (without prior vasectomy).
- Some similarity to salpingitis isthmica nodosa.[4]
Gross
- Mass.
Microscopic
Features:[4]
- 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.
- Lined by columnar/cuboidal epithelium.
- +/-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:[5]
- May "invade" vascular spaces - associated with elastosis (breakdown of elastic fibres[6]).
Image:
IHC
- PSA -ve.
- PSAP -ve.
Bilateral absence of the vas deferens
- Seen in cystic fibrosis.
See also
References
- ↑ URL: http://www.upmccancercenters.com/cancer/prostate/radprostretropubic.html. Accessed on: 26 September 2011.
- ↑ 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.
- ↑ Sasaki, K.; Bastacky, SI.; Zynger, DL.; Parwani, AV. (Dec 2009). "Use of immunohistochemical markers to confirm the presence of vas deferens in vasectomy specimens.". Am J Clin Pathol 132 (6): 893-8. doi:10.1309/AJCPQZX4WS8UPKGG. PMID 19926581.
- ↑ 4.0 4.1 4.2 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/.
- ↑ Balogh, K.; Travis, WD. (Apr 1985). "Benign vascular invasion in vasitis nodosa.". Am J Clin Pathol 83 (4): 426-30. PMID 3984936.
- ↑ URL: http://medical-dictionary.thefreedictionary.com/elastosis. Accessed on: 26 September 2011.