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An electron microscopic study of the ductuli efferentes and rete testis of the guinea pig.

The ductuli efferentes and rete testis of the guinea pig were isolated by micro dissection, fixed in cold buffered osmium tetroxide, and sectioned for examination with the light and electron microscopes. Proximal and distal segments of the ductuli efferentes were identified and their respective cytological organizations characterized. The cytological components of the rete testis are briefly described and figured. Non-ciliated and ciliated cells are found in both segments of the ductuli efferentes. The non-ciliated cells have a microvillous border, mitochondria, a Golgi complex, an ubiquitous endoplasmic reticulum, and numerous cytoplasmic vacuoles. The ciliated cells contain more mitochondria, an endoplasmic reticulum with a relatively sparse distribution, and few, if any, cytoplasmic vacuoles. A regional difference exists in proximal and distal segments based on the distribution, size, number, and electron opacity of the cytoplasmic vacuoles. Attention was paid to the disposition of the endoplasmic reticulum and its relation to the system of cytoplasmic vacuoles. These findings are interpreted as suggesting that the continuity of the vacuolar system with elements of the endoplasmic reticulum represents a pathway for transfer of large quantities of fluid, an activity which has long been ascribed to the epithelium of the ductuli efferentes. Periductular capillaries possess pore-like apertures in their endothelia similar to those in other tissues known to engage in fluid transfer.

Animals↗

Steroid entry into rete testis fluid and the blood-testis barrier.

Evidence that steroids enter rete testis fluid (RTF) from the blood at varying rates was obtained during i.v. infusions into rats. Testosterone and dehydroepiandrosterone were readily transferred into the fluid, whereas cholesterol was excluded. Between these extremes, the appearance of radioactivity in the RTF suggested the following order of entry rate: progesterone greater than pregnenolone greater than 5-alpha-reduced androgens greater than oestrogens greater than corticosteroids. Preliminary identification of metabolites in RTF and blood suggested that testosterone and dehydroepiandrosterone were transferred largely unchanged. Androstenedione and progesterone, however, were largely metabolized during transfer into the RTF, the former being transformed to testosterone. The results are used to discuss the nature of the blood-testis barrier to steroids and the source of androgens in the RTF.

Androgens↗

The effect of rete testis fluid on the metabolism of testicular spermatozoa.

The O2 uptake of spermatozoa collected from the rete testis of conscious rams and boars has been measured polarographically either in the rete testis fluid (RTF) in which they were collected or in a synthetic saline medium (S-RTF) made to resemble the ionic composition of RTF as closely as possible. In both species, O2 uptake of the testicular spermatozoa was higher in RTF than in S-RTF. The addition of some of the organic constituents of RTF was without effect on O2 uptake. Pyruvate, lactate, acetate or alanine increased the O2 consumption of ram spermatozoa in S-RTF. Lactate had no effect on but acetate increased the O2 consumption of pig testicular spermatozoa. Phospholipid phosphorus and fatty acids decreased during incubation of ram spermatozoa in RTF and S-RTF. The addition of substances which increased the O2 consumption of the spermatozoa in S-RTF was without effect on the lipid composition. The fatty acid composition of the phospholipids and the proportions of the various phospholipids were unaffected by incubation. These results indicate that rete testis fluid has an appreciable effect on the metabolism of the spermatozoa it contains, and that this effect cannot be mimicked by any of the known organic constituents of the fluid.

Animals↗

Primary adenocarcinoma of the rete testis with preceding diagnosis of pulmonary metastases.

We report a case of primary adenocarcinoma of the rete testis in a 55-year-old man with pulmonary metastases that were detected 11 months prior to the diagnosis of the primary lesion. Primary adenocarcinoma of the rete testis is an extremely rare malignant tumor with a poor outcome. The most common primary symptom is a scrotal mass, often accompanied by hydrocele and chronic epididymitis. The diagnosis is often delayed because of non-specific clinical presentation and symptoms. We cannot forget that rete testis is a possible primary site for a primary, unknown metastatic adenocarcinoma.

Adenocarcinoma↗

Morphology of the rat rete testis in experimental autoimmune orchitis.

The role of the rete testis and related structures in the development of experimental autoimmune orchitis (EAO) was studied in adult inbred Sprague-Dawley rats. Histology and electron microscopy showed focal perivascular infiltration and an increase in the number of mast cells and polymorphonuclears. Often there were vacuolated macrophages. These changes were first observed two weeks after the beginning of immunization, but they did not clearly precede lesions in seminiferous tubules. Increased amounts of cellular debris appeared in rete cavities, suggesting damage to germinal epithelium. Lanthanum tracer studies of immunized rats showed local lesions in the blood-testis barrier of the seminiferous tubules but did not indicate spreading of lesions from the rete testis. Efferent duct ligation of immunized rats for 24 h did not increase the frequency of lesions. The present observation do not support the theory that the rete testis is the route of spreading of EAO.

Animals↗

On the morphology of the transitional zones from the rete testis into the ductuli efferentes and from the ductuli efferentes into the ductus epididymidis. Investigations on the human testis and epididymis.

Transitions from the rete testis into the ductuli efferentes and from the ductuli efferentes into the ductus epididymidis were examined in the epididymes of 4 patients with prostatic cancer aged 65, 72, 77 and 78 years, in the epididymis of a 19 year-old accident victim and in the epididymis of an embryo of the 12th week. Concerning the former area, the results published up to now were confirmed. But according to our examinations, the transition from the ductuli efferentes into the ductus epididymidis is different from what has been described in the literature so far. In the adult human, the ductuli efferentes do not show end-to-side connections with the ductus epididymidis, but end-to-end junctions with "extensions" of the ductus epididymidis which finally join the ductus epididymidis end-to-side. However, in the epididymis of the embryo, one still finds end-to-side connections of ductuli efferentes and the ductus epididymidis. It was concluded that the extensions of the ductus epididymidis are formed during the development of the system of canaliculi in the epididymis from the embryonal stage to adult age.

Adult↗

Rete testis mucinous adenocarcinoma in a dog.

A bilateral testicular neoplasm from an 11-year-old mixed-breed male dog was removed surgically and examined histologically. The neoplasm was nonencapsulated and composed of acinar and tubular structures lined by one or more layers of neoplastic polyhedral epithelial cells with an abundant mucinous secretion. On histochemistry, all neoplastic cells and associated secretions were periodic acid-Schiff positive. Some neoplastic cells and all associated secretions were positive on mucicarmine stain, and some neoplastic cells, all the stroma, and associated secretions were positive on alcian blue stain. On immunohistochemistry, the neoplastic cells had strong diffuse cytoplasmic immunoreactivity for cytokeratin and vimentin, weak scattered cytoplasmic immunoreactivity for carcinoembryonic antigen and neuron-specific enolase, and no immunoreactivity for S-100. On the basis of histopathology, histochemistry, and immunohistochemical findings, a diagnosis of mucinous adenocarcinoma of rete testis was made. Rete testis adenocarcinoma is a well known but very rare neoplasm in humans. To our knowledge, this is the first report of the mucinous variant of adenocarcinoma of the rete testis in a dog.

Adenocarcinoma, Mucinous↗

Tubular ectasia of the rete testis: a potential pitfall in scrotal imaging.

Tubular ectasia of the rete testis (TERT) is a benign entity due to dilation of the tubules of the rete testis. Most of the time it is discovered incidentally on scrotal sonograms and may be misinterpreted as malignant. This article outlines the diagnostic criteria of TERT, its possible causes, its incidence and its potential evolution. Recognizing this entity owing to its characteristic clinical, sonographic and, if necessary, MRI features is important to avoid unnecessary surgery or biopsies.

Diagnosis, Differential↗

Adenofibroma of the rete testis. A case report with electron microscopy findings.

The light and electron microscopic characteristics of an adenofibroma of the rete testis in a 51-year-old man are described. The tumor was 5.5 cm in greatest diameter and situated in the anterior superior portion of the right testis. It was composed mainly of mesenchymal and secondary epithelial proliferation. Long slit-like spaces and short tubules lined by a layer of epithelial cells were seen in the mesenchymal tissue. The epithelium was histochemically and ultrastructurally similar to that of the rete testis, and the tumor was considered to be of rete testis origin.

Adenofibroma↗

Cystic transformation and calcium oxalate deposits in rete testis and efferent ducts in dialysis patients.

The histological study of the testes and epididymides obtained from autopsies of 24 men with chronic renal insufficiency revealed bilateral cystic transformation of the rete testis and efferent ducts in patients who underwent hemodialysis or peritoneal dialysis, but not in patients who did not receive this treatment. The lesion was associated with an accumulation of crystalline calcium oxalate deposits in the lumen of the rete testis and efferent ducts, and in the connective tissue adjacent to these excretory ducts. The rete testis epithelium showed columnar transformation with occasional papillary proliferations. Neither atypias or mitoses were observed. In three specimens, fibrosis and giant cell reactions was also present in the rete testis at the level of crystalline deposits. In three specimens, the caput epididymidis was enlarged, and the efferent ducts showed an increase in both tubular diameter and epithelial height, irregular outline, and development of diverticula. The lesions appeared within 30 months after the onset of dialysis.

Adult↗

The connection between the seminiferous tubules and the rete testis in the domestic fowl (Gallus domesticus). Morphological study.

The tubules connecting the seminiferous tubules proper to the rete testis in the fowl were studied with the aid of light and electron microscopy. The material examined ultrastructurally was fixed by vascular perfusion through the thoracic aorta. The seminiferous tubules were joined to the rete testis in three different ways; they were either linked by a terminal segment and a tubulus rectus, by a terminal segment only, or opened directly into the rete cavities. The terminal segment of the seminiferous tubules was lined with columnar cells (modified Sertoli cells). These cells were characterized by having an indented nucleus with a prominent nucleolus, many mitochondria, a sizable Golgi apparatus, electron dense bodies and many cytoplasmic protrusions into the lumen. Intraepithelial lymphocytes as well as macrophages in the lumina of the terminal segment, the tubuli recti and the rete testis were also observed. Myoid cells were found in the boundary tissue of the terminal segment.

Animals↗

Adenocarcinoma of the rete testis: a review of the literature and presentation of a case with associated asbestosis.

Although scattered reports of adenocarcinoma of the rete testis have previously appeared and criteria for the diagnosis of this tumor have been defined, previous cases have not been described in sufficient detail to provide an organized account of the nature and behavior of this neoplasm. The present report describes a case followed to autopsy and provides conclusive evidence that it is of rete testis origin. Previously reported cases of rete testis carcinoma are reviewed and the salient features summarized, showing that the tumor has a definite clinical and histologic pattern and that the prognosis appears poor. The present case occurred in a patient with severe pulmonary asbestosis. This association is unique, and its significance remains speculative.

Aged↗

[Tubular ectasia of the rete testis: ultrasonography findings in 19 patients].

OBJECTIVE: The sonographic findings and associated etiological conditions in 19 patients with tubular ectasia of the rete testis are described. METHODS: 19 patients with tubular ectasia of the rete testis diagnosed by ultrasound over a two-year period are presented. Twenty-seven testes showed ectasia. The mean age at the time of diagnosis was 59 years. US evaluation was performed with the 7-8 MHz multifrequency linear probe (Acuson 128, Mountain View, CA, USA). The patients were evaluated in the supine position and the scrotal content was examined in the sagittal and transverse planes. A color and pulsed Doppler study were performed in all the cases. RESULTS: 8 patients showed bilateral involvement, 7 had left and 4 right tubular ectasia. Other frequently associated findings were spermatocele (8 cases), cord cyst (6 cases) and varicocele (5 cases). Four patients had undergone scrotal surgery and one had a previous history of epididymitis. CONCLUSIONS: Tubular ectasia of the rete testis is an uncommon, benign condition that is usually associated with epididymal obstruction following trauma or infection in most of the cases. Diagnosis of tubular ectasia by US, in a correct clinical context, obviates the need to perform a biopsy and orchidectomy for its diagnosis in a vast majority of the cases.

Adolescent↗

Endocytosis in epithelial cells lining the rete testis of the rat.

The endocytic activity of the low cuboidal cells lining the rete testis was analyzed by electron microscopy following injection of various tracers into the lumen of these anastomotic channels. At 1 and 5 minutes after injection, cationic ferritin (CF) and concanavalin A-ferritin (Con A) were seen bound to the apical plasma membrane and to the membrane of subjacent vesicles or invaginations connected to this apical membrane. At 30 and 60 minutes, these tracers were found in intracytoplasmic vesicles and in vesicles connected to the lateral or basal plasma membrane as well as in the lateral intercellular space and in the lamina lucida of basal lamina. At 30 minutes, CF and Con A also appeared in the matrix of pale multivesicular bodies while at 1 hour dense multivesicular bodies were labeled. At 2 hours and later time intervals, the tracers accumulated in dense granules identified as lysosomes. Native ferritin (NF), concanavalin A-ferritin in presence of alpha-methyl-D-mannoside, and horseradish peroxidase or albumin bound to colloidal gold were all to be incorporated by the lysosomal system of these epithelial cells, as just described for CF and Con A, but these various tracers were not bound to the apical plasma membrane or to the membrane of cytoplasmic vesicles, nor were they found in the intercellular spaces or the lamina lucida at the base of the cells. Thus, the epithelial cells of the rete testis do not appear to be only involved in the uptake of substances from the lumen and their disposal by the lysosomal system, but also appear to contribute to the transport of certain macromolecules from the lumen to the laterobasal surfaces of the cells. These cells may thus play a role in determining the composition of the rete testis fluid.

Albumins↗

Microlithiasis of the epididymis and the rete testis.

Testicular microlithiasis is a well-defined clinical and pathologic entity easily diagnosed through testicular echography; however, its association with cancer and infertility is now under debate. Many efforts have been done in recent years to clarify the spectrum of lesions observed in testicular microlithiasis, but no published data as to the existence of a possible microlithiasis of the epididymis and the rete testis have been found. We have observed microlithiasis of the epididymis and the rete testis in surgical (8 epididymis and 6 testis) and autopsy specimens (12 cases). In decreased order of frequency, microliths of the proximal spermatic way were seen in rete testis, epididymal duct, and efferent ducts. Intraluminal, subepithelial, and interstitial microliths were localized along these segments of the spermatic way. Subepithelial microliths were the most frequently found. A granulomatous reaction around the interstitial epididymal microliths, mimicking malacoplakia, was observed in 1 case. The differential diagnosis of microliths includes corpora amilacea, Michaelis-Gutmann bodies, calcium deposits, hyaline globules, and parasites, like the giant kidney worm Dioctophyme renale. In infants and young adults, microlithiasis of the epididymis and the rete testis is frequently associated with alterations in the development of the proximal spermatic way. In elderly adults, it is related to ischemia and obstruction of the spermatic way.

Adolescent↗

Adenomatous hyperplasia of the rete testis in the undescended testis.

Multiple foci of micronodular or tubulopapillary structures were noted in the rete testis of 13 cases of undescended testes. These structures were lined by low columnar to cuboidal epithelium, showed back-to-back crowding, and were supported by a thin lamina propria. These changes, referred to as adenomatous hyperplasia of the rete testis, appear to be a frequent finding in the undescended testis. An age-matched control group did not show any of these features.

Adolescent↗

[Tubular ectasia of the rete testis. The echographic aspects].

Tubular ectasia of the seminiferous tubules of the rete testis is an uncommon benign condition which was only recently described. Its US pattern is typical and allows the disease to be distinguished from cystic tumors of the testicle. The condition was evaluated with US in 10 patients; all men were over 50 years old. US was performed with a 7.5-MHz linear probe. The lesion was unilateral in 7 and bilateral in 3 patients. It was always localized in the mediastinum testis and was associated with spermatocele in 5 cases and with testicular cysts in 4. On US scans, the condition presented with several tubular or rounded anechoic structures, mimicking a hypoechoic mass. In 5 men with 4-19 months' follow-up, no change in lesion size and structure was observed. Tubular ectasia was never assessed with biopsy or histology. Tubular ectasia of the rete testis shares several US features with testicular cysts and spermatocele, which are likely to have the same underlying mechanisms. This benign condition can be distinguished from true cysts and testicular tumors on the basis of US findings and its differential diagnosis is important to avoid unnecessary surgery.

Aged↗

Cystic transformation of the rete testis.

In a review of the testicular and epididymal specimens obtained from autopsies (1,798 men) or surgery (518 men), cystic transformation of the rete testis (CTRT) was found in 20 autopsies and 18 surgical specimens. When both testes were studied (autopsies), the lesion was bilateral. Ultrasonography revealed a widened mediastinum testis showing small hypoechoic areas. Arteriography showed thin or irregularly outlined testicular arteries, and the epididymal artery was lacking or appeared stenosed. Simple CTRT (without epithelial alteration) was found in both testes of 17 autopsied patients (all were elderly men) and in eight surgically removed testes from patients with sarcoma, tuberculous orchidoepididymitis, or hematocele. The most frequent epididymal lesion was bilateral efferent duct atrophy. In three patients, the rete testis presented nodular proliferation of calcifying connective tissue. CTRT with columnar transformation of the rete testis epithelium was observed in both testes from three patients with alcoholic cirrhosis, and in 10 surgically removed testes from patients with testicular tumor, cryptorchidism, or nonspecific orchitis. In cirrhotic patients, the efferent ducts appeared atrophied. In patients with testicular tumors, the efferent ducts were infiltrated by carcinoma in situ cells (CISs) and often contained granular material, cell debris, or hyaline globules. In both kinds of CTRT (without or with epithelial metaplasia), the most frequent seminiferous tubule lesions were tubular ectasia, hypospermatogenesis, tubular sclerosis, spermatogonium arrest, and sloughing of immature germ cells (spermatids and spermatocytes). The mechanism leading to CTRT might be mechanic (compression of the epididymis by an epididymal tumor or a spermatic cord tumor, or the result of a long-standing epididymitis or traumatic hemocele); ischemic (autopsied elderly men); hormonal (cirrhotic patients); malformative (cryptorchidism); or unknown (the remaining cases).

Adolescent↗