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Received: 25 March 2021    Accepted: 26 June 2021

DOI: 10.1111/rda.13985

S H O R T C O M M U N I C AT I O N

Tubular ectasia of the rete testis in an Angus bull

Katelyn Waters1 | Julie Gard Schnuelle1  | Lawerence Grady Cofield1 | Jessica Rush1 |

Yatta Boakari1 | Jessica Cowley1 | Katharine Horzmann2

1
Department of Clinical Sciences, College
of Veterinary Medicine, Auburn University,
Auburn, AL, USA
2
Department of Pathobiology, College of
Veterinary Medicine, Auburn University,
Auburn, AL, USA
Correspondence
Julie Gard Schnuelle, Department of Clinical
Sciences, College of Veterinary Medicine,
Auburn University, Auburn, AL 36849, USA.
Email: waldrja@auburn.edu
Abstract
An 18-­month-­old Angus bull presented to Auburn University College of Veterinary
Medicine for a routine breeding soundness evaluation and lameness evaluation. He
was classified as deferred potential breeder due to a lameness and was donated to
the university. Following treatment, the bull's lameness resolved. He passed the
breeding soundness examination in accordance with the Society for Theriogenology
standards. However, avascular dilated areas at the level of the mediastinum testis of
the right testicle were detected via Doppler ultrasonography. A high level of vascular-
ity is routinely seen with neoplasia, such as teratomas. Due to the lack of vascularity,
a presumptive diagnosis of tubular ectasia of the rete testis was made. The bull was
castrated. The right testicle was submitted for histopathology revealing a definitive
diagnosis of tubular ectasia of the rete testis.

KEYWORDS

breeding, bull, Doppler ultrasonography, ectasia, fertility, rete testis

soundness examination (BSE) and lameness evaluation. The bull was

1 |  I NTRO D U C TI O N
Tubular ectasia of the rete testis is a benign, dilation or destruction
of the rete testis (Nair et al., 2008). The rete testis is a network of
tubules that allow the passage of spermatozoa from the seminif-
erous tubules to the efferent ducts (Gadodia et al., 2010; Hess &
Hermo, 2018). The seminiferous tubules develop from the rete tes-
tes into lobules that make up the testicular parenchyma, spanning
the entire distance from the core to the tunica albuginea (Gadodia
et al., 2010; Hess & Hermo, 2018).
2 |  C A S E H I S TO RY A N D C LI N I C A L
FI N D I N G S
All procedures were performed in accordance with the Institutional
Animal Care and Use Standards. An 18-­month-­old Angus bull pre-
sented to Auburn University College of Veterinary Medicine Large
Animal Teaching Hospital (AUCVMLATH) for a routine breeding
identified as a deferred potential breeder due to his left rear lame-
ness and donated to the AUCVMLATH. His spermatozoa evaluation
was satisfactory with a progressive motility of 60% and a normal
morphology of 76%. The percentage of spermatozoa abnormalities
consisted of head (8%), midpiece (15%) and tail (1%). The bull had a
satisfactory scrotal circumference of 37.5 cm. Digital examination of
the right and left testicles, spermatic cord and head, body and tail
of the epididymis revealed no palpable abnormalities in consistency
or size. Two months later, the bull's lameness resolved. The bull un-
derwent a subsequent BSE. The bull was determined to have a sat-
isfactory scrotal circumference (36 cm), progressive motility (60%)
and normal morphology of 72%. The spermatozoa abnormalities
included head (10%), midpiece (16%) and tail (2%). Transrectal palpa-
tion revealed accessory sex glands that were all within normal limits.
Upon digital examination of the testicles, asymmetry between the
right and left testicle was visually appreciated with the right testi-
cle being slightly smaller than the left but with normal consistency.
Digital examination revealed no palpable abnormalities or differ-
ences in size or consistency between the head, body and tail of the

Katelyn Waters and Julie Gard Schnuelle are joint first authors.

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1262       WATERS et al.
right and left epididymis. A decrease of 1.5 cm in the scrotal cir-
cumference was noted from the previous measurement. The normal
consistency of testicular tissue on palpation is that of a semi-­flex
muscle. If the consistency of testicular tissue is less firm or firmer
than a semi-­flexed muscle, then the testicle is considered abnormal.
Further examination of the testicles utilizing ultrasound, EXApad
mini ultrasound with Doppler and a 10 MHZ rectal probe; (Universal
Imaging; Bedford Hills, New York) revealed numerous dilated areas
throughout the mediastinum testis extending to the rete testes
(Figure 1.). The dilated areas were measured using the ultrasound
(Universal Imaging) calliper function and found to be 0.05–­0.35 cm
in diameter. The mediastinum testis is normally hyperechoic when
visualized with ultrasound (Figure 2.). Colour Doppler ultrasound
revealed the absence of vascularity in the mediastinum testis and
along the area of the rete testis in the right testicle (Figure 3 and
Figure 4.). The diameter of the mediastinum of the affected and un-
affected testicles was 1.0 cm and 0.5 cm, respectively. No adjacent
masses in the testicle were identified further ruling out a concurrent
neoplastic process.
The bull was castrated. Post-­castration excisional biopsies of
1.0 cm by 1.0 cm size were collected from the right and left scrotal
sac, epididymis and testicles and submitted for gross and histologic
examination to the AUCVM Pathology Laboratory. The tissues were
placed in Bouin's fixative (Sigma-­Aldrich) followed by 95% alcohol
(Sigma-­Aldrich) to remove the Bouin's solution. Finally, the tissues
were placed in 10% non-­buffered saline (Sigma-­Aldrich), sectioned
and stained with haematoxylin and eosin (Sigma-­Aldrich) in accor-
dance with the AUCVM Histology Laboratory standard procedures.
Histopathologic evaluation revealed marked diffuse testicular de-
generation and atrophy throughout the testicle. The seminiferous
tubules displayed varying stages of degeneration. Almost all tubules
had reduced tubule diameter with complete absence of spermato-
zoa. The interstitium contained multifocal areas expanded by fi-
brous connective tissue, which surrounded various seminiferous
tubules (Figure 5.). The rare seminiferous tubules that contained
F I G U R E 1   Ultrasound image of the dilated areas throughout the
longitudinal view of the mediastinum testis and rete testis of the
affected right testicle
spermatozoa were either partially mineralized or had areas of os-
seous metaplasia. Multifocal lymphocytic aggregates were present
in the interstitium. The Sertoli cells were diffusely vacuolated and
depleted (Figure 5.). The right epididymis was void of spermatozoa
(Figure 6.), but no other abnormalities were noted. These findings
were consistent with the diagnosis of tubular ectasia of the rete
testis.
3 | D I S CU S S I O N
Tubular ectasia of the rete testis is a rare finding in domestic
mammals (Chambers et al., 2014; Gadodia et al., 2010; Gelberg &
McEntee, 1983; Kutzler et al., 2006; Wakui et al., 1997). Unilateral
tubular ectasia of the rete testis may be an incidental finding with no
clinical signs unless bilateral blockage occurs, causing azoospermia.
However, in up to one-­third of men affected, ectasia of the rete tes-
tis is bilateral and can present as a non-­painful scrotal swelling (Nair
et al., 2008). The bull in this report had slight testicular asymmetry,
but there was no evidence of scrotal swelling. If testicular ultrasound
had not been performed, the bull may have been considered a sat-
isfactory breeder.
Once tubular ectasia of the rete testis is determined, it is import-
ant to differentiate tubular ectasia of the rete testis from a testicular
neoplasm. The most common malignant testicular tumour with sim-
ilar ultrasonographic findings to those seen with tubular ectasia of
the rete testis is a teratoma (Nair et al., 2008). Doppler ultrasound
(EXApad mini, Universal Imaging), revealed severely decreased
vascularity of the rete testis of the bull in this report, which is con-
sidered pathognomonic for ectasia, where a teratoma will have an
abundance of vascularity (Nair et al., 2008; Pandya et al., 2016). In
humans, only a small portion of testicular tumours are benign (Nair
et al., 2008). Hence, swift identification of tumours is necessary to
rule out malignant neoplastic processes. Men diagnosed with tubu-
lar ectasia of the rete testis can be managed with conservative med-
ical treatment and monitoring (Nair et al., 2008; Pandya et al., 2016).
Serial ultrasonographic measurements of the cystic areas and rou-
tine assessment of serum tumour markers are imperative to avoid
unilateral orchidectomy in men (Nair et al., 2008). However, bulls
are usually not afforded this luxury unless their genetics are valu-
able and the aetiology is determined not to be heritable in nature.
The bull, in this case, underwent bilateral castration and was sold
to slaughter.
The most common aetiology of tubular ectasia of the rete tes-
tis is acquired and is often due to mechanical compression of the
epididymis or spermatic cord such as trauma, surgical manipulation
or crushing, and or prolonged periods of epididymitis and neoplas-
tic processes. (Chambers et al., 2014; Gadodia et al., 2010; Gelberg
& McEntee, 1983; Kutzler et al., 2006; Nair et al., 2008; Wakui
et al., 1997). Mechanical obstruction may result from procedures
such as vasectomy or fibrosis following testicular inflammation
(Gadodia et al., 2010; Pandya et al., 2016). Mechanical obstruction
of the efferent tubules at the level of the head of the epididymis
WATERS et al.
F I G U R E 2   Ultrasound image of the longitudinal view of the
mediastinum testis of the unaffected left testicle
F I G U R E 3   Colour Doppler ultrasound image of the avascular
dilated areas throughout the cross-­sectional view of the
mediastinum testis of the affected right testicle
leads to dilation in the proximal ductal system resulting in dilation
of the rete testis (Nair et al., 2008). Congenital malformations that
are considered heritable such as cryptorchidism and polyorchidism
are thought to play a role (Nair et al., 2008; Schumacher et al., 1994).
Cases of aplasia of the mesonephric ducts have been reported and
determined to be congenital in origin (Williams et al., 2010).
Tubular ectasia of rete testis has been reported in multiple
species including an alpaca, a cat, a fox, a rabbit, a stallion and an
efferent ductule cyst in a dog (Chambers et al., 2014; Gelberg &
McEntee, 1983; Kutzler et al., 2006; Schumacher et al., 1994; Wakui
et al., 1997). These cases had varying aetiology. Tubular ectasia of
the rete testis of the cat was thought to be due to a congenital defect
(Gelberg & McEntee, 1983), the fox's condition was due to a semi-
noma (Gelberg & McEntee, 1983), the stallion was attributed to the
affected testicle being retained (Schumacher et al., 1994), and the
rabbit experienced dysplastic tissue formation within the testicle,
which resulted in ectasia of the rete testis. (Chambers et al., 2014).
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F I G U R E 4   Colour Doppler ultrasound image of the avascular
dilated areas throughout the longitudinal view of the mediastinum
testis of the affected right testicle
F I G U R E 5   Post-­castration excisional biopsy: histologic aspect
(200x magnification, haematoxylin-­and-­eosin-­stained) of the
seminiferous tubuli in the affected testicle showing varying degrees
of degeneration. Many of the represented tubules are devoid of
spermatogenic cells (black arrows)
The aetiology was not definitive in the alpaca and was attributed to
chronic inflammation (Kutzler et al., 2006). Due to the young age of
the bull in this report, asymmetry and lack of palpable fibrosis, it is
likely that testicular inflammation and/or trauma resulted in fibrosis
with non-­neoplastic osseous metaplasia. Osseous metaplasia can
occur secondary to trauma and inflammation, haematoma formation
and tumours (Lee et al., 2011). The lack of vascularity of mediasti-
num testis, rete testis and within the testicular parenchyma in this
bull was consistent with a non-­neoplastic process. There were no
detected blockages or abnormalities of the right or left epididymis
upon gross or histologic examination, aside from lack of spermatozoa
on the right side. Hence, congenital abnormalities and mechanical
obstruction of the epididymis were ruled out.
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1264       WATERS et al.
F I G U R E 6   Post-­castration excisional biopsy: histologic aspect
(40x magnification, haematoxylin-­and-­eosin-­stained). The head of
the epididymis is completely devoid of spermatozoa
The bull in this report was considered an unsatisfactory breeder
since one testicle was non-­functional. Scrotal circumference is used
as a rough estimate of the spermatic output. A true ejaculate, in-
cluding sperm concentration, is not collected routinely during a BSE
in bulls. Hence, addition of routine testicular and epididymal ultra-
sonography to the bull BSE can aid in identification of sub-­fertile
bulls due to anatomic abnormalities such as tubular ectasia of the
rete testis.
In conclusion, tubular ectasia of the rete testis is a rare, inci-
dental finding in bulls with the possibility of different aetiologies.
Abnormalities of the rete testis, as was found in this report, can be
catastrophic to the reproductive viability of the affected testicle.
Tubular ectasia of the rete testis should be differentiated from tes-
ticular neoplasia via Doppler ultrasonography evaluation and evalu-
ated for congenital aetiology to prevent transmission to offspring.
C O N FL I C T O F I N T E R E S T
The authors declare no conflicts of interest.
AU T H O R C O N T R I B U T I O N S
Dr. Schnuelle was the lead clinician on the case and provided the ul-
trasound images and is co-­author of the manuscript with Dr. Waters.
Dr. Schnuelle involved in the aspects of the manuscript preparation
and review along with addressing the revision and resubmission of
the manuscript. Dr. Waters co-­authored this manuscript and involved
in revisions of the manuscript. Drs. Rush and Cofield were involved
with the case management of the bull. Drs. Boakari and Cowley as-
sisted with the review of the manuscript. Dr. Horzmann was the
boarded pathologist on the case and provided histologic and gross
reports of the submitted tissues and provided the haematoxylin-­
and-­eosin-­stained images.
DATA AVA I L A B I L I T Y
The data that support the findings of this study are available from
the corresponding author upon reasonable request.
ORCID
Julie Gard Schnuelle  https://orcid.org/0000-0003-1851-634X
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How to cite this article: Waters, K., Schnuelle, J. G., Cofield, L.
G., Rush, J., Boakari, Y., Cowley, J., & Horzmann, K. (2021).
Tubular ectasia of the rete testis in an Angus bull. Reproduction
in Domestic Animals, 56, 1261–­1264. https://doi.org/10.1111/
rda.13985