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Vascular Pathology Related to Extracellular Material Accumulation

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Clues in the Diagnosis of Non-tumoral Testicular Pathology

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Abstract

Extracellular materials that can accumulate on the wall of the testicular vessels are varied. All have in common that they originate directly from the blood. Histologically they are acellular eosinophilic deposits. Depending on the type of material, they preferably affect the intimae, the media or the vascular adventitia, or even the lumen or the wall of the seminiferous tubules. The three most common diseases with vascular extracellular deposits are arteriolar hyalinosis, disseminated intravascular coagulation (DIC), and amyloidosis. The differential diagnosis between these entities usually presents no difficulties. But if we take into account the severity of the pathology of patients with DIC and amyloidosis and the resemblance of some lesions, especially in early stages, to a banal lesion such as arteriolar hyalinosis, then accuracy in diagnosis is necessary. This chapter is devoted to the differential diagnosis of accumulated materials through the study of biopsies, surgical specimens, and autopsies in which there is an important testicular involvement. Testicular lesions in different types of amyloidosis deserve special attention.

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References

  1. Moritz AR, Oldt MR. Arteriolar sclerosis in hypertensive and non-hypertensive individuals. Am J Pathol. 1937;13:679–728.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. Nistal M, Potenciano J, Contreras F. La hialinización arteriolar del testículo. Arch Esp Urol. 1973;26:481–500.

    Google Scholar 

  3. Hatakeyama S, Sengoku R, Takayama S. Histological and submicroscopic studies on arteriolar hyalinosis of the human testis. Bull Tokyo Med Dent Univ. 1966;13:511–30.

    CAS  PubMed  Google Scholar 

  4. Dustin P. Arteriolar hialinosis. In: Richter GW, Epstein MA, editors. International Review of Experime. Virchows Arch A Pathol Anat Histol. 1979;381:269–81.

    Google Scholar 

  5. Frei D, Hedinger C. Arteriolar hyalinosis in testicular biopsies (author’s transl). [Article in German]. Virchows Arch A Pathol Anat Histol. 1979;381:269–81.

    Article  CAS  PubMed  Google Scholar 

  6. Robboy SJ, Major MC, Colman RW, JD M. Pathology of disseminated intravascular coagulation (DIC). Analysis of 26 cases. Hum Pathol. 1972;3:327–43.

    Article  CAS  PubMed  Google Scholar 

  7. Wada H, Matsumoto T, Yamashita Y. Diagnosis and treatment of disseminated intravascular coagulation (DIC) according to four DIC guidelines. J Interprof Care. 2014;2:15–22.

    Google Scholar 

  8. Breccia M, Lo CF. Thrombo-hemorrhagic deaths in acute promyelocytic leukemia. Thromb Res. 2014;133(Suppl 2):S112–6.

    Article  CAS  PubMed  Google Scholar 

  9. Sallah S, Wan JY, Nguyen NP, Hanrahan LR, Sigounas G. Disseminated intravascular coagulation in solid tumors: clinical and pathologic study. Thromb Haemost. 2001;86:828–33.

    CAS  PubMed  Google Scholar 

  10. Hwang IG, Choi JH, Park SH, Oh SY, Kwon HC, Lee SI, Lim d H, GW L, JH K. Chemotherapy in advanced gastric cancer patients associated with disseminated intravascular coagulation. Cancer Res Treat. 2014;46:27–32.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. van Bunderen CC, de Weger VA, Griffioen-Keijzer A. Disseminated intravascular coagulation as clinical manifestation of colorectal cancer: a case report and review of the literature. Neth J Med. 2014;72:186–9.

    PubMed  Google Scholar 

  12. Okamoto K, Tamura T, Sawatsubashi Y. Sepsis and disseminated intravascular coagulation. J Interprof Care. 2016;4:23.

    Google Scholar 

  13. Levi M. Disseminated intravascular coagulation in cancer patients. Best Pract Res Clin Haematol. 2009;22:129–36.

    Article  PubMed  Google Scholar 

  14. Merlini G, Bellotti V. Molecular mechanisms of amyloidosis. N Engl J Med. 2003;349:583–96.

    Article  CAS  PubMed  Google Scholar 

  15. Röcken C, Sletten K. Amyloid in surgical pathology. Virchows Arch. 2003;443:3–16.

    Article  PubMed  Google Scholar 

  16. Hachulla E, Grateau G. Diagnostic tools for amyloidosis. Joint Bone Spine. 2002;69:538–45.

    Article  PubMed  Google Scholar 

  17. Caporali R, Bonacci E, Epis O, Bobbio-Pallavicini F, Morbini P, Montecucco C. Safety and usefulness of minor salivary gland biopsy: retrospective analysis of 502 procedures performed at a single center. Arthritis Rheum. 2008;59:714–20.

    Article  PubMed  Google Scholar 

  18. van Gameren II, Hazenberg BP, Bijzet J, van Rijswijk MH. Diagnostic accuracy of subcutaneous abdominal fat tissue aspiration for detecting systemic amyloidosis and its utility in clinical practice. Arthritis Rheum. 2006;54:2015–21.

    Article  PubMed  Google Scholar 

  19. Ozdemir BH, Ozdemir OG, Ozdemir FN, Ozdemir AL. Value of testis biopsy in the diagnosis of systemic amyloidosis. Urology. 2002;59:201–5.

    Article  PubMed  Google Scholar 

  20. Howie AJ, Owen-Casey MP. Discrepancies between descriptions and illustrations of colours in Congo red-stained amyloid, and explanation of discrepant colours. Amyloid. 2010;17:109–17.

    Article  PubMed  Google Scholar 

  21. Fujihara S, Balow JE, Costa JC, Glenner GG. Identification and classification of amyloid in formalin-fixed, paraffin-embedded tissue sections by the unlabeled immunoperoxidase method. Lab Invest. 1980;43:358–65.

    CAS  PubMed  Google Scholar 

  22. Lachmann HJ, Booth DR, Booth SE, Bybee A, Gilbertson JA, Gillmore JD, Pepys MB, Hawkins PN. Misdiagnosis of hereditary amyloidosis as AL (primary) amyloidosis. N Engl J Med. 2002;346:1786–91.

    Article  CAS  PubMed  Google Scholar 

  23. Arbustini E, Verga L, Concardi M, Palladini G, Obici L, Merlini G. Electron and immuno-electron microscopy of abdominal fat identifies and characterizes amyloid fibrils in suspected cardiac amyloidosis. Amyloid. 2002;9:108–14.

    CAS  PubMed  Google Scholar 

  24. Vrana JA, Gamez JD, Madden BJ, Theis JD, Bergen 3rd HR, Dogan A. Classification of amyloidosis by laser microdissection and mass spectrometry-based proteomic analysis in clinical biopsy specimens. Blood. 2009;114:4957–9.

    Article  CAS  PubMed  Google Scholar 

  25. Kyle RA, Gertz MA. Primary systemic amyloidosis: clinical and laboratory features in 474 cases. Semin Hematol. 1995;32:45–59.

    CAS  PubMed  Google Scholar 

  26. de Asúa D R, Costa R, JM G, MT F, Trujillo D, Cadiñanos J. Systemic AA amyloidosis: epidemiology, diagnosis, and management. Clin Epigenetics. 2014;6:369–77.

    Google Scholar 

  27. Baux E, Henard S, Alauzet C, Goehringer F, Laurain C, Champigneulle J, Vaillant P, Hardy A, Rabaud C, May T. AA-type amyloidosis secondary to multidrug resistant pulmonary tuberculosis: implications for therapy. Rev Pneumol Clin. 2015;71:297–300.

    Article  CAS  PubMed  Google Scholar 

  28. Akpolat T, Akpolat l, Kandemir B. Behcet’s disease and AA-type amyloidosis. Am J Nephrol. 2000;20:68–70.

    Article  CAS  PubMed  Google Scholar 

  29. Escriba A, Morales E, Albizua E, Herrero JC, Ortuño T, Carreño A, Dominguez-Gil B, Praga M. Secondary (AA-type) amyloidosis in patients with polymyalgia rheumatica. Am J Kidney Dis. 2000;35:137–40.

    Article  CAS  PubMed  Google Scholar 

  30. Lejmi H, Jen KY, Olson JL, James SH, Sam R. Characteristics of AA amyloidosis patients in San Francisco. Nephrology (Carlton). 2016;21:308–13.

    Article  CAS  Google Scholar 

  31. Handelsman DJ, Yue DK, Turtle JR. Hypogonadism and massive testicular infiltration due to amyloidosis. J Urol. 1983;129:610–2.

    CAS  PubMed  Google Scholar 

  32. Shirahama T, Miura K, Ju ST, Kisilevsky R, Gruys E, Cohen AS. Amyloid enhancing factor-loaded macrophages in amyloid fibril formation. Lab Invest. 1990;62:61–8.

    CAS  PubMed  Google Scholar 

  33. Sohar E, Gafni J, Pras M, Heller H. Familial Mediterranean fever. A survey of 470 cases and review of the literature. Am J Med. 1967;43:227–53.

    Article  CAS  PubMed  Google Scholar 

  34. Pras E, Livneh A, Balow Jr JE, Pras E, Kastner DL, Pras M, Langevitz P. Clinical differences between North African and Iraqi Jews with familial Mediterranean fever. Am J Med Genet. 1998;75:216–9.

    Article  CAS  PubMed  Google Scholar 

  35. Eshel G, Zemer D, Bar-Yochai A. Acute orchitis in familial Mediterranean fever. Ann Intern Med. 1988;109:164–5.

    Article  CAS  PubMed  Google Scholar 

  36. Livneh A, Madgar I, Langevitz P, Zemer D. Recurrent episodes of acute scrotum with ischemic testicular necrosis in a patient with familial Mediterranean fever. J Urol. 1994;151:431–2.

    CAS  PubMed  Google Scholar 

  37. Corvino C, Balloni F, Meliani E, Giannini A, Serni S, Carini M. Testicular amyloidosis. Urol Int. 2002;69:162–3.

    Article  CAS  PubMed  Google Scholar 

  38. Unger PD, Wang Q, Gordon RE, Stock R, Stone N. Localized amyloidosis of the seminal vesicle. Possible association with hormonally treated prostatic adenocarcinoma. Arch Pathol Lab Med. 1997;121:1265–8.

    CAS  PubMed  Google Scholar 

  39. Ishihara T, Takahashi M, Koga M, Yokota T, Yamashita Y, Uchino F. Amyloid fibril formation in the rough endoplasmic reticulum of plasma cells from a patient with localized A lambda amyloidosis. Lab Invest. 1991;64:265–71.

    CAS  PubMed  Google Scholar 

  40. Cornwell 3rd GG, Westermark GT, Pitkanen P, Westermark P. Seminal vesicle amyloid: the first example of exocrine cell origin of an amyloid fibril precursor. J Pathol. 1992;167:297–303.

    Article  PubMed  Google Scholar 

  41. Campistol JM, Cases A, Torras A, Soler M, Muñoz-Gómez J, Montoliu J, López-Pedret J, Revert L. Visceral involvement of dialysis amyloidosis. Am J Nephrol. 1987;7:390–3.

    Article  CAS  PubMed  Google Scholar 

  42. Esslimani M, Serre I, Granier M, Robert M, Baldet P, Costes V. Urogenital amyloidosis: clinico-pathological study of 8 cases. Ann Pathol. 1999;19:487–91.

    CAS  PubMed  Google Scholar 

  43. Nagasaka T, Togashi S, Watanabe H, Iida H, Nagasaka K, Nakamura Y, Miwa M, Kobayashi F, Shindo K, Shiozawa Z. Clinical and histopathological features of progressive-type familial amyloidotic polyneuropathy with TTR Lys54. J Neurol Sci. 2009;276:88–94.

    Article  CAS  PubMed  Google Scholar 

  44. Andersson R, Hofer PA. Genitourinary disturbances in familial and sporadic cases of primary amyloidosis with polyneuropathy. Acta Med Scand. 1974;195:49–58.

    Article  CAS  PubMed  Google Scholar 

  45. Andeen NK, Lam DY, de Boer IH, Nicosia RF. Renal ApoA-1 amyloidosis with Glu34Lys mutation and intra-amyloid lipid accumulation. J Am Soc Nephrol. 2014;25:2703–5.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Gregorini G, Izzi C, Ravani P, Obici L, Dallera N, Del Barba A, Negrinelli A, Tardanico R, Nardi M, Biasi L, Scalvini T, Merlini G, Scolari F. Tubulointerstitial nephritis is a dominant feature of hereditary apolipoprotein A-I amyloidosis. Kidney Int. 2015;87:1223–9.

    Article  CAS  PubMed  Google Scholar 

  47. Scalvini T, Martini PR, Gambera A, Tardanico R, Biasi L, Scolari F, Gregorini G, Agabiti RE. Spermatogenic and steroidogenic impairment of the testicle characterizes the hereditary leucine-75-proline apolipoprotein a-I amyloidosis. J Clin Endocrinol Metab. 2008;93:1850–3.

    Article  CAS  PubMed  Google Scholar 

  48. Tripathi VN, Desautels RE. Primary amyloidosis of the urogenital system: a study of 16 cases and brief review. J Urol. 1969;102:96–101.

    CAS  PubMed  Google Scholar 

  49. Casella R, Nudell D, Cozzolino D, Wang H, Lipshultz LI. Prymary testicular amyloidosis mimicking tumor in a cryptorchid testis. Urology. 2002;59:445.

    Article  PubMed  Google Scholar 

  50. Nistal M, Santamaria L, Codesal J, Paniagua R. Secondary amyloidosis of the testis: an electron microscopic and histochemical study. Appl Pathol. 1989;7:2–7.

    CAS  PubMed  Google Scholar 

  51. Mazanec K, McClure J, Bartley CJ, Newbould MJ, Ackrill P. Systemic amyloidosis of beta 2 microglobulin type. J Clin Pathol. 1992;45:832–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Ohashi K, Takagawa R, Hara M. Visceral organ involvement and extracellular matrix changes in beta 2-microglobulin amyloidosis–a comparative study with systemic AA and AL amyloidosis. Virchows Arch. 1997;430:479–87.

    Article  CAS  PubMed  Google Scholar 

  53. Ohashi K, Kisilevsky R, Yanagishita M. Affinity binding of glycosaminoglycans with beta (2)-microglobulin. Nephron. 2002;90:158–68.

    Article  CAS  PubMed  Google Scholar 

  54. Schrepferman CG, Lester DR, Sandlow JI. Testicular amyloid deposition as a cause of secondary azoospermia. Urology. 2000;55:145.

    Article  CAS  PubMed  Google Scholar 

  55. Okada H, Fujisawa M, Arakawa S, Hanioka K, Kamidono S. Bilateral testicular enlargement in an infertile man. BJU Int. 2001;88:640–1.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Universidad Autónoma de Madrid (UAM), Department of Anatomy, Histology and Neuroscience, School of Medicine, Madrid, Spain

    Manuel Nistal

  2. School of Medicine, Universidad Autónoma de Madrid (UAM), University Hospital La Paz, Department of Pathology, Madrid, Spain

    Pilar González-Peramato

  3. University Hospital Clinico San Carlos, Department of Urology, Madrid, Spain

    Álvaro Serrano

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  1. Manuel Nistal
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  2. Pilar González-Peramato
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  3. Álvaro Serrano
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Correspondence to Manuel Nistal .

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Nistal, M., González-Peramato, P., Serrano, Á. (2017). Vascular Pathology Related to Extracellular Material Accumulation. In: Clues in the Diagnosis of Non-tumoral Testicular Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-49364-0_25

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  • DOI: https://doi.org/10.1007/978-3-319-49364-0_25

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