Pathology Secondary to Metastatic Tumours in the Lymphatic Vessels of the Spermatic Cord

The study of the lymphatic vessels is part of testicular tumour staging since most tumours that metastasize do so through the lymphatic vessels. This is usually done in transverse, proximal, medial, and distal sections of the spermatic cord. Identification of the lymphatic vessels may, in some cases, require specific markers (D2–40). In these cases, the composition of the lymph is very different from what is usual, and it may carry tumour cells as well as by-products of tumoural necrosis. Many of these products have a direct action on the vascular endothelium and in some cases on the entire vessel wall. The response is highly variable, ranging from non-specific to the development of sarcoid-like granulomas. This different way of reacting seems to be related to the type of testicular tumour.