Flickinger C J, Herr J C, Sisak J R, Howards S S
Department of Anatomy and Cell Biology, School of Medicine, University of Virginia Health Sciences Center, Charlottesville.
Anat Rec. 1993 Jan;235(1):61-73. doi: 10.1002/ar.1092350107.
The response of the male reproductive tract to vasectomy includes inflammation of the interstitial tissue of the epididymis. The pathogenesis of epididymal interstitial reactions and characteristics of the responding cells were studied by electron microscopy in Lewis rats at intervals following bilateral vasectomy, vasectomy followed 1 month later by vasovasostomy, or sham operations. In areas of interstitial reaction, numerous macrophages, monocytes, lymphocytes, neutrophils, and plasma cells occupied the connective tissue. Macrophages, containing many lysosomes and vesicles, aggregated and assumed the appearance of epithelioid cells. Processes of adjacent macrophages interdigitated with one another and closely approached the surfaces of lymphocytes. Many plasma cells with distended rough endoplasmic reticulum appeared in the interstitium. The majority of animals in the vasectomy and vasovasostomy groups exhibited epididymal interstitial changes by 2-3 months; the cauda epididymidis was the region most often affected. The ultrastructural features were indicative of chronic granulomatous inflammation and were consistent with an immune response that includes antigen presentation by macrophages to lymphocytes, lymphocyte differentiation, and local antibody production by plasma cells. The nearly complete absence of sperm or recognizable parts thereof in the interstitial tissue in the areas of the reactions suggests that these lesions formed in response to soluble antigens leaking from the duct. Vasovasostomy was not effective in reversing or retarding epididymal inflammation at the intervals studied.
雄性生殖道对输精管结扎术的反应包括附睾间质组织的炎症。通过电子显微镜对双侧输精管结扎术后、输精管结扎术后1个月再行输精管吻合术或假手术的Lewis大鼠，在不同时间间隔研究附睾间质反应的发病机制及反应细胞的特征。在间质反应区域，大量巨噬细胞、单核细胞、淋巴细胞、中性粒细胞和浆细胞占据结缔组织。含有许多溶酶体和小泡的巨噬细胞聚集并呈现上皮样细胞的外观。相邻巨噬细胞的突起相互交错，并紧密靠近淋巴细胞表面。间质中出现许多粗面内质网扩张的浆细胞。输精管结扎组和输精管吻合术组的大多数动物在2 - 3个月时出现附睾间质变化；附睾尾部是最常受影响的区域。超微结构特征表明为慢性肉芽肿性炎症，与免疫反应一致，包括巨噬细胞向淋巴细胞呈递抗原、淋巴细胞分化以及浆细胞产生局部抗体。反应区域间质组织中几乎完全没有精子或其可识别的部分，这表明这些病变是对从管道中漏出的可溶性抗原的反应而形成的。在所研究的时间间隔内，输精管吻合术对于逆转或延缓附睾炎症无效。
