inguinal glandular inclusions

Glandular inclusions in inguinal hernia sacs have resemblance to the epididymis or vas deferens. Most of hernia sac inclusions, we thought were Mullerian duct-derived structures.

Types

 CD10- vas deferens-like
 CD10 +/- epididymis-like
 CD10- Mullerian-like
 external diameter < 1 mm

Differential diagnosis

 transected vas deferens

• CD10+
• external diameter > 1 mm

Immunochemistry

 inguinal hernia sac glandular inclusions are CD10-

• CD10+ in Wolffian-type epithelium
• CD10- in Mullerian-type epithelium

References

 Cerilli LA, Sotelo-Avila C, Mills SE. Glandular inclusions in inguinal hernia sacs: morphologic and immunohistochemical distinction from epididymis and vas deferens. Am J Surg Pathol. 2003 Apr;27(4):469-76. PMID: 12657931

 Gomez-Roman JJ, Mayorga M, Mira C, Buelta L, Fernandez F, Val-Bernal JF. Glandular inclusions in inguinal hernia sacs: a clinicopathological study of six cases. Pediatr Pathol. 1994 Nov-Dec;14(6):1043-9. PMID: 855006

 Walker AN, Mills SE. Glandular inclusions in inguinal hernial sacs and spermatic cords. Mullerian-like remnants confused with functional reproductive structures. Am J Clin Pathol. 1984 Jul;82(1):85-9. PMID: 6741877