Microlithiasis of the Epididymis and the Rete Testis
Microlithiasis of the Epididymis and the Rete Testis
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DOI：
10.1097/00000478-200404000-00011
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发表时间：
2004-04
期刊：
影响因子：
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通讯作者：
M. Nistal;Miguel Ángel García-Cabezas;J. Regadera;M. C. Castillo
中科院分区：
文献类型：
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作者：
M. Nistal;Miguel Ángel García-Cabezas;J. Regadera;M. C. Castillo
睾丸微石症是一种明确的临床和病理实体，可通过睾丸回波描记术轻松诊断。然而，它与癌症和不孕不育的关系目前仍存在争议。近年来，人们做出了许多努力来澄清睾丸微石症中观察到的病变范围，但尚未发现关于附睾和睾丸网可能存在微石症的公开数据。我们在手术标本（8例附睾和6例睾丸）和尸检标本（12例）中观察到附睾和睾丸网微石症。按照频率递减的顺序，在睾丸网、附睾管和传出管中可见近端精索的微石。腔内、上皮下和间质微石位于精索道的这些部分。上皮下微石是最常见的。 1 例观察到附睾间质微石周围出现类似软斑的肉芽肿反应。微石的鉴别诊断包括细石体、米氏小体、钙沉积物、透明球和寄生虫，如巨型肾蠕虫肾丝线虫。在婴儿和年轻人中，附睾和睾丸网的微石症通常与近端精索发育的改变有关。在老年人中，它与缺血和精索通道阻塞有关。
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.