Skip to main content
SpringerLink
Log in

Acquired Cystic Transformation of the Rete Testis (Cystic Ectasia of the Rete Testis)

  • Chapter
  • First Online:
Clues in the Diagnosis of Non-tumoral Testicular Pathology

  • 1179 Accesses

Abstract

One of the most serious consequences of obstruction of the spermatic ducts, and especially when it affects epididymis, is the sudden interruption of the flow of testicular fluid. As the production of testicular fluid is continuous, a retrograde dilation of the anterior segment of the spermatic ducts occurs that ends dilating the rete testis. From a histological point of view, three types of cystic transformation of the rete testis can be identified: simple, with epithelial changes, and with crystal deposits. Each of these three types presents different problems. The simple cystic transformation can be so important that it poses problems of differential diagnosis with both malformation processes of rete testis (simple cyst, cystic dysplasia of the rete testis), and two tumors of the rete testis (cystadenoma and cystadenocarcinoma) and germ cell tumors that may consist preferably of cystic formations, or with vascular pathology (intratesticular varicocele). Cystic transformation with epithelial changes occurs in patients with certain underlying conditions due to increased estrogen, and the epithelium acquires a cubic aspect. Finally, the cystic transformation of the rete testis with crystalline deposits is characteristic of patients with chronic kidney disease and is a form of oxalosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Yeung CH, Cooper TG, Bergmann M, Schulze H. Organization of tubules in the human caput epididymidis and the ultrastructure of their epithelia. Am J Anat. 1991;191:261–79.

    Article  CAS  PubMed  Google Scholar 

  2. Jonté G, Holstein AF. On the morphology of the transitional zones from the rete testis into the ductuli efferentes and from the ductulie fferentes into the ductus epididymidis. Investigations on the human testis and epididymis. Andrologia. 1987;19:398–412.

    Article  PubMed  Google Scholar 

  3. Saitoh K, Terada T, Hatakeyama S. A morphological study of the efferent ducts of the human epididymis. Int J Androl. 1990;13:369–76.

    Article  CAS  PubMed  Google Scholar 

  4. Hermo L, Morales C. Endocytosis in nonciliated epithelial cells of the ductuliefferentes in the rat. Am J Anat. 1984;171:59–74.

    Article  CAS  PubMed  Google Scholar 

  5. Ilio KY, Hess RA. Structure and function of the ductuliefferentes: a review. Microsc Res Tech. 1994;29:432–67.

    Article  CAS  PubMed  Google Scholar 

  6. Arrighi S, Ventriglia G, Aralla M, Zizza S, Di Summa A, Desantis S. Absorptive activities of the efferent ducts evaluated by the immunolocalization of aquaporin water channels and lectin histochemistry in adult cats. Histol Histopathol. 2010;25:433–44.

    CAS  PubMed  Google Scholar 

  7. Pelliniemi LJ, Dym M, Gunsalus GL, Musto NA, Bardin CW, Fawcett DW. Immunocytochemical localization of androgen-binding protein in the male rat reproductive tract. Endocrinology. 1981;108:925–31.

    Article  CAS  PubMed  Google Scholar 

  8. Pereira MF, Fernandes SA, Nascimento AR, Siu ER, Hess RA, Oliveira CA, Porto CS, Lazari MF. Effects of the oestrogen receptor antagonist Fulvestrant on expression of genes that affect organization of the epididymal epithelium. Andrology. 2014;2:559–71.

    Article  CAS  PubMed  Google Scholar 

  9. Osman DI. On the ultrastructure of modified Sertoli cells in the terminal segment of seminiferous tubules in the boar. J Anat. 1978;127:603–13.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Weingarten BJ, Kellman GM, Middleton WD, Gross ML. Tubular ectasia within the mediastinum testis. J Ultrasound Med. 1992;11:349–53.

    Article  CAS  PubMed  Google Scholar 

  11. Nistal M, Mate A, Paniagua R. Cystic transformation of the rete testis. Am J Surg Pathol. 1996;20:1231–9.

    Article  CAS  PubMed  Google Scholar 

  12. Brown DL, Benson CB, Doherty FJ, Doubilet PM, DiSalvo DN, Van Alstyne GA, Vickers MA, Loughlin KR. Cystic testicular mass caused by dilated rete testis: sonographic findings in 31 cases. AJR Am J Roentgenol. 1992;158:1257–9.

    Article  CAS  PubMed  Google Scholar 

  13. Gooding GA, Leonhardt W, Stein R. Testicular cysts: US findings. Radiology. 1987;163:537–8.

    Article  CAS  PubMed  Google Scholar 

  14. Rouvière O, Bouvier R, Pangaud C, Jeune C, Dawahra M, Lyonnet D. Tubular ectasia of the rete testis: a potential pitfall in scrotal imaging. Eur Radiol. 1999;9:1862–8.

    Article  PubMed  Google Scholar 

  15. Nistal M, Santamaría L, Paniagua R. Acquired cystic transformationof the rete testis secondary to renal failure. Hum Pathol. 1989;20:1065–70.

    Article  CAS  PubMed  Google Scholar 

  16. Colangelo SM, Fried K, Hyacinthe LM, Fracchia JA. Tubular ectasia of the rete testis: an ultrasound diagnosis. Urology. 1995;45:532–4.

    Article  CAS  PubMed  Google Scholar 

  17. Ortega Herrera R, Medina Benítez A, López Milena G. Tubular ectasia of the rete testis: ultrasonography findings in 19 patients. Arch Esp Urol. 2000;53:455–9. [in Spanish].

    CAS  PubMed  Google Scholar 

  18. Pascual Mateo C, Fernández González I, LujánGalán M, Rodríguez García N, Espinales Castro G, Berenguer Sánchez A. Cystic ectasia of the rete testis. Arch Esp Urol. 2006;59:55–8. [in Spanish].

    Article  PubMed  Google Scholar 

  19. Thomas RD, Dewbury KC. Ultrasound appearances of the rete testis. Clin Radiol. 1993;47:121–4.

    Article  CAS  PubMed  Google Scholar 

  20. Pavlica P, Ramini R, Barozzi L. Tubular ectasia of the rete testis. The echographic aspects. Radiol Med. 1994;87:493–7.

    CAS  PubMed  Google Scholar 

  21. Tartar VM, Trambert MA, Balsara ZN, Mattrey RF. Tubular ectasia of the testicle: sonographic and MR imaging appearance. AJR Am J Roentgenol. 1993;160:539–42.

    Article  CAS  PubMed  Google Scholar 

  22. Meyer DR, Huppe T, Lock U, et al. Pronounced cystic transformation of the rete testis: MRI appearance. Invest Radiol. 1999;34:600–3.

    Article  CAS  PubMed  Google Scholar 

  23. Eberli D, Gretener H, Dommann-Scherrer C, Pestalozzi D, Fehr JL. Cystic dysplasia of the testis: a very rare paediatric tumor of the testis. Urol Int. 2002;69:1–6.

    Article  PubMed  Google Scholar 

  24. Weiss AJ, Kellman GM, Middleton WD, Kirkemo A. Intratesticular varicocele: sonographic findings in two patients. AJR Am J Roentgenol. 1992;158:1061–3.

    Article  CAS  PubMed  Google Scholar 

  25. Stewart VR, Sidhu PS. The testis: the unusual, the rare and the bizarre. Clin Radiol. 2007;62:289–302.

    Article  CAS  PubMed  Google Scholar 

  26. Hansen N, Sanchez R, Ivancic V. Unusual combination of bilateral testicular microlithiasis and tubular ectasia of the rete testis with left intra- and extratesticular varicocele in a 17-year-old boy. J Clin Ultrasound. 2012;40:314–8.

    Article  PubMed  Google Scholar 

  27. Gabriel H, Marko J, Nikolaidis P. Cystadenoma of the rete testis: sonographic appearance. AJR Am J Roentgenol. 2007;189:W67–9.

    Article  PubMed  Google Scholar 

  28. Sahnan K, Manjunath A, Vaughan-Shaw PG, Mitsopoulos G. An unexpected finding of a rare intrascrotal lesion: the sertoliform cystadenoma of the rete testis. BMJ Case Rep. 2013. pii: bcr2012008439.

    Google Scholar 

  29. Stein JP, Freeman JA, Esrig D, Chandrasoma PT, Skinner DG. Papillary adenocarcinoma of the rete testis: a case report and review of the literature. Urology. 1994;44:588–94.

    Article  CAS  PubMed  Google Scholar 

  30. Hamm B, Fobbe F, Loy V. Testicular cysts: differentiation with US and clinical findings. Radiology. 1988;168:19–23.

    Article  CAS  PubMed  Google Scholar 

  31. Regadera J, Nistal M, Paniagua R. Testis, epididymis, and spermatic cord in elderly men. Correlation of angiographic and histologic studies with systemic arteriosclerosis. Arch Pathol Lab Med. 1985;109:663–7.

    CAS  PubMed  Google Scholar 

  32. Jimenez-López M, Ramírez-Garrido F, López-González Garrido JD, Mantas-Avila JA, Nogueras-Ocaña M, Jimenez-Verdejo A, Fernández-Mena J. Dilatation of the rete testis: ultrasoundstudy. Eur Radiol. 1999;9:1327–9.

    Article  PubMed  Google Scholar 

  33. Nistal M, Paniagua R, Regadera J, Santamaria L. Obstruction of the tubuli recti and ductuliefferentes by dilated veins in the testes of men with varicocele and its possible role in causing atrophy of the seminiferous tubules. Int J Androl. 1984;7:309–23.

    Article  CAS  PubMed  Google Scholar 

  34. Tchetgen MB, Wolf Jr JS. Postsurgical changes in the testis: a diagnostic dilemma. Urology. 1998;51:333–4.

    Article  CAS  PubMed  Google Scholar 

  35. Wilschanski M, Corey M, Durie P, et al. The diversity of reproductive tract abnormalities in males with cystic fibrosis. JAMA. 1996;276:607–8.

    Article  CAS  PubMed  Google Scholar 

  36. Mayfield M, Edwards P, Dundas S. An unusual case of testicular pain. Br J Urol. 1996;77:471–2.

    Article  CAS  PubMed  Google Scholar 

  37. Newbold RR, Bullock BC, McLachlan JA. Lesions of the rete testis in mice exposed prenatally to diethylstilbestrol. Cancer Res. 1985;45:5145–50.

    CAS  PubMed  Google Scholar 

  38. Bullock BC, Newbold RR, McLachlan JA. Lesions of testis and epididymis associated with prenatal diethylstilbestrol exposure. Environ Health Perspect. 1988;77:29–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Aceitero J, Llanero M, Parrado R, Peña E, Lopez-Beltran A. Neonatal exposure of male rats to estradiol benzoate causes rete testis dilation and backflow impairment of spermatogenesis. Anat Rec. 1998;252:17–33.

    Article  CAS  PubMed  Google Scholar 

  40. Naito M, Hirai S, Terayama H, Qu N, Hayashi S, Hatayama N, Kawamura H, Nakano T, Itoh M. Neonatal estrogen treatment with β-estradiol 17-cypionate induces in post-pubertal mice inflammation in the ductuliefferentes, epididymis, and vas deferens, but not in the testis, provoking obstructive azoospermia. Med Mol Morphol. 2014;47:21–30.

    Article  CAS  PubMed  Google Scholar 

  41. Karagiannis A, Harsoulis F. Gonadal dysfunction in systemic diseases. J Clin Endocrinol Metab. 1988;67:639–43.

    Article  Google Scholar 

  42. Coyne J, al-Nakib L, Goldsmith D, O’Flynn K. Secondary oxalosis and sperm granuloma of the epididymis. J Clin Pathol. 1994;47:470–1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Concolino G, Lubrano C, Ombres M, et al. Acquired cystic kidney disease: the hormonal hypothesis. Urology. 1993;41:170–5.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

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

Authors
  1. Manuel Nistal
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pilar González-Peramato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Álvaro Serrano
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Manuel Nistal .

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Nistal, M., González-Peramato, P., Serrano, Á. (2017). Acquired Cystic Transformation of the Rete Testis (Cystic Ectasia of the Rete Testis). In: Clues in the Diagnosis of Non-tumoral Testicular Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-49364-0_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-49364-0_30

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-49363-3

  • Online ISBN: 978-3-319-49364-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation