In the more chronic forms, the tubules become atrophied, and frequently disappear entirely. The membrana propria may become thickened, due to excessive connective tissue formation, or infiltration with serum or exudate. On the other hand, a distinct atrophy may occur. The stroma of the organ not infrequently is thickened by inflammatory exudates, or by a noticeable increase in the connective tissue. In some testes, the connective tissue is so much increased that the tubules rapidly become atrophied, and disappear. In abscess formation, due to acute inflammations, the entire organ becomes enlarged, markedly hyperaemic, and infiltrated with leucocytes. Necrotic areas appear here and there in the parenchyma. The rete often shows a marked degeneration of the lining epithelium, and atrophy caused by increase of the interstitial connective tissue.
Epididymis: This organ not infrequently presents gross abnormalities, and very often is pathological on microscopic examination. Acute, inflammation, with induration or abscess formation, is very common in the tail, but less so in the head and body. Possibly this is caused by the fact that the tail is the most pendant portion of the organ. In these cases, the tail is enlarged, soft, and quite hot and painful on physical examination. Enlargement, due to a connective tissue induration, occurs occasionally in all three parts, and the inflammation may produce adhesions to the adjacent serous membranes. Inflammation of both the parietal and visceral layers of the tunica vaginalis is very common. In those cases, the membrane usually is quite hyperaemic, and on the surface it presents many small reddened tufts of newly-formed connective tissue. In adult bulls it is exceptional not to find at least slight evidence of some previous inflammation. In all of the numerous bulls examined, both apparently normal and sterile, I have found but one in which some evidence of inflammation (either present or past) could not be found. Along with the fibrous tufts, are numerous fine strands of connective tissues passing from the covering of the tail of the epididymis to the adjacent portion of the parietal layer of the tunica. The strands often extend even to the upper part of the head.
Microscopically, inflammation of the part is shown by hyperaemia, loss of cilia of the lining cells, and exudation. In the more severe forms, the lining cells which furnish considerable secretion for the nourishment and stimulation of the sperms, become degenerated, and are exfoliated into the lumen, as in Fig. 21. This condition is very common in sterile bulls, and those of lowered fertility. In the chronic types, the interstitial connective tissue is increased in amount, leading to degeneration and atrophy of part or all of the tubules, as in the case of Bull 2. Infiltration with leucocytes, and necrosis, are the predominating lesions in the pyogenic types of inflammation.
Ductus Deferens: This tube seems to be peculiarly free from severe inflammatory processes, and when these appear they are limited to the mucosa. The cells of the lining membrane not infrequently show a mild type of degeneration and exfoliation, or in the more chronic forms, the entire membrane degenerates and disappears. In man, the duct occasionally becomes occluded, but so far I have failed to find this condition in the bull. Undoubtedly, when the occlusion does occur, it is near the origin of the duct at the tail of the epididymis.
Seminal Vesicles: The seminal vesicles and epididymis, especially the tail, seem to be the parts most subject to extensive pathological changes, and bacterial invasion. In most instances, diseased vesicles present gross manifestations recognizable on clinical examination, while on the other hand microscopic changes may be present in the absence of gross lesions. As diagnosed on physical examination, or even on post mortem examination of the tract, the various forms may be classified into:
1. Acute Catarrhal Type: In this form, the vesicles are usually enlarged, soft, and more or less reddened by hyperaemia. On physical examination of the animal, distinct flinching is produced when pressure is applied to the organ. Enlargement may even be absent in the early stages, and the diagnosis may be made from the extreme sensitiveness alone.
2. Suppurative or Cystic Types: In both of these types, the vesicles are usually enlarged, either uniformly, or, as is usually the case, in localized areas. The suppurative form may extend over the entire gland, forming one large encapsulated abscess, or on the other hand, it may take the form of variable sized abscesses with thick sclerotic, or thin fluctuating walls. Occasionally the abscesses rupture and discharge their contents into the rectum. Dr. Williams presented one case of this type. One vesicle was apparently normal, whereas the other was about five times larger than normal, and consisted of a dense outer capsule which was adherent to all surrounding parts. On dissection, it was found that the organ consisted of abscesses of various sizes, the larger one of which had ruptured some time previously into the rectum, leaving the distinct remains of an opening into that part. The cystic form may occur either with or without suppuration. One case came to my attention in which both vesicles were made up of abscesses of varying sizes as well as of a smaller number of cysts. Evidently the cysts were of the retention type, and were secondary to the pyogenic infection.
3. Chronic or Sclerotic Type: This form is characterized by a distinct firmness with or without marked enlargement. The condition may be accompanied by disease of the parenchymatous tissue or it may take the form of a chronic productive inflammation of the interstitial tissue. This inflammation may be simply a superficial thickening, or it may extend in between the lobules.
4. The Peri-vesicular or “pan-inflammatory” Type usually is the result of severe inflammation of the vesicles, with probable rupture of some of the smaller cysts or abscesses upon the surface. The vesicles are, as a rule, considerably enlarged and buried in a dense mass of adhesions which involve neighboring structures. The vesicles cannot be palpated on physical examination, and it is only on careful post mortem dissection that they may be studied. This type, however, is quite rare,—two cases only having come to my attention. In both, the vesicles themselves were markedly affected.
Microscopically, changes in the vesicles are quite frequently encountered, even in the absence of gross manifestations. In the acute catarrhal forms, the mucosa and submucosa are hyperaemic. The lining cells show various forms of degeneration, and there are, as a rule, inflammatory exudates in the lumen. As the inflammation progresses, the lining cells degenerate further, and become cast off into the lumen of the glandular cavities, as in Plate VI. The normal clear mucous secretion becomes mixed with fibrin, leucocytes, and cellular debris. These changes may involve merely parts of the organ, or they may be quite extensive. With large sections, one may find the inflammation in all stages, from the mildest catarrhal type, to complete degeneration and exfoliation of the secretion-forming mucosal cells, and filling of the cavities with degenerated cells, leucocytes, and debris. Frequently the interstitial tissue is in no way affected, but at times it is thickened by oedematous exudates, leucocytes, and fibrin. The chronic interstitial form is characterized by a considerable increase of connective tissue,—producing marked atrophy, or even complete obliteration of the glandular cavities. Microscopically the suppurative form may be diffuse over the entire gland, or as stated previously, may be in the form of localized abscesses, with or without a thick connective tissue wall. The parenchyma in these cases is usually extensively degenerated and atrophied in those parts that have not undergone suppuration and necrosis. The cysts appear to be of the ordinary retention type, and may or may not be accompanied by extensive changes in the lining epithelium.