Pseudoangiomatous Stromal Hyperplasia (PASH) of the Breast

Drinka, Eva; Bargaje, Archana; Erşahin, Çağatay; Patel, Priya; Salhadar, Alia; Sinacore, James; Rajan, Prabha

doi:10.1177/1066896911418643

Cited by 47 publications

(75 citation statements)

References 20 publications

(35 reference statements)

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“…57 The detailed clinical presentation, morphology, immunophenotype, and behavior of PASH were described in several large studies. [58][59][60] In the skin, PASH was recognized in 2005. 11 Like gestational gynecomastia, PASH appears to represent an abnormal proliferative stromal response to estrogen, which can be blocked by Tamoxifen.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Gigantomastia, Multiple Synchronous Nodular Pseudoangiomatous Stromal Hyperplasia Involving Breast and Bilateral Axillary Accessory Breast Tissue, and Perianal Mammary-Type Hamartoma of Anogenital Mammary-Like Glands

Hayes

Konstantinova

Kacerovská

et al. 2016

The American Journal of Dermatopathology

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Mammary-type fibroepithelial lesions involving ectopic breast and anogenital region are rare and usually coexist with normal orthotopic breast. We present what we believe to be a unique case of synchronous bilateral gestational gigantomastia resembling fibrous mastopathy, synchronous rapidly growing pregnancy-associated nodular pseudoangiomatous stromal hyperplasia involving right breast and bilateral axillary ectopic breast tissue, and metachronous perianal mammary-type hamartoma involving anogenital mammary-like glands occurring in a 34-year-old patient with facioscapulohumeral muscular dystrophy. Also, we review the literature concerning these lesions.

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Section: Discussionmentioning

confidence: 99%

Bilateral Gigantomastia, Multiple Synchronous Nodular Pseudoangiomatous Stromal Hyperplasia Involving Breast and Bilateral Axillary Accessory Breast Tissue, and Perianal Mammary-Type Hamartoma of Anogenital Mammary-Like Glands

Hayes

Konstantinova

Kacerovská

et al. 2016

The American Journal of Dermatopathology

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“…Excisional biopsy was deemed too high a risk for causing damage to the breast bud due to the inability to distinguish it from the tumour, therefore, an incisional biopsy was the treatment of choice 11. PASH lesions are not known to metastasise, however, local recurrences have been described; rates ranging from 0% to 22% and largely attributed to incomplete excision or presence of unknown multifocal lesions 3 12–14. PASH is not thought to be a premalignant condition and does not confer any increased risk for malignancy as evidenced by a large retrospective case series of 579 cases of biopsy-proven PASHs 15.…”

Section: Discussionmentioning

confidence: 99%

“…Pathologically the distinctive features are lack of true vessels and no cytological pleomorphism in PASH. The lining cells in PASH are not endothelial in origin; on immunostaining they show variable CD34 expression and are negative for other endothelial markers (eg CD31, factor VIII, ERG) 3. Angiosarcoma, however, would be expected to have positive expression of CD34, CD31, ERG and factor VIII 4…”

Section: Differential Diagnosismentioning

confidence: 99%

Giant pseudoangiomatous stromal hyperplasia presenting in the breast of a prepubertal child

et al. 2015

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Large benign lesions of the breasts are rare in children. We present a case of a 35 cm mass, weighing 2.7 kg in a 13-year-old girl with small developing breasts. Despite the enormity of the lesion, the patient managed to keep it concealed from her parents for 8 months. While initially suspicious of sarcoma a diagnosis of pseudoangiomatous stromal hyperplasia was suggested radiologically and confirmed histologically. Excision with reduction mammoplasty was performed, care taken not to disrupt the remaining breast tissue to facilitate future breast development. 18 months on, the cosmetic appearance of the breasts is good, with healthy underlying breast tissue developing. To the best of our knowledge this case is the largest documented breast tumour of this type in a patient of this age and illustrates the challenge of treating such tumours in the developing breast.

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“…The histopathological differential diagnosis of PASH includes benign and malignant lesions of the breast, such as myofibroblastoma and low grade angiosarcoma (3,10). Myofibroblastoma is also a well-circumscribed, slowly growing, nodular lesion that is generally located in the subareolar region.…”

Section: Discussionmentioning

confidence: 99%

“…We mostly characterize PASH as an incidental finding accompanying several benign or malignant lesions of breast while evaluating the surgical excision specimens microscopically. Occasionally, it may comprise a mass and therefore present as a palpable nodule clinically (3). It has been reported as either a rapidly enlarging nodule suspicious of malignancy or direct transformation to malignancy in single case reports (4,5).…”

Section: Introductionmentioning

confidence: 99%

Nodule-Forming Pseudoangiomatous Stromal Hyperplasia of the Breast: Report of Three Cases

Kelten¹,

Boyacı²,

Leblebıcı³

et al. 2015

J Breasth Health

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Pseudoangiomatous stromal hyperplasia (PASH) is a benign proliferative entity of mammary stroma. It is generally found as an incidental finding. It may rarely present as a palpable nodule. Three patients, who were 29, 45, and 58 years of age, were referred to our clinic with nodule and pain in the breast. The physical examinations and ultrasound findings of all three patients were consistent with fibroadenoma. Core biopsies were performed and reported as "benign breast parenchyma including stromal fibrosis." PASH areas were noted in one case. The excision specimens were observed as solid nodular masses with smooth external surfaces and white in colour. Microscopically, well-demarcated hyalinized stroma, including slit-like pseudovascular spaces lined by bland spindle cells, was observed. Immunohistochemically, these cells showed positive staining for CD34 and negative staining for CD31. Nodule-forming PASH mostly confuses with fibroadenoma with respect to clinical examination and radiological findings. Definite diagnosis requires histopathological verification. Differential diagnosis should be made with low grade angiosarcoma, fibroepithelial tumors, and myofibroblastoma.

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Pseudoangiomatous Stromal Hyperplasia (PASH) of the Breast

Abstract: Based on these results, extensive sampling of biopsy specimen with PASH and appropriate clinical and radiologic follow-up is recommended.

Cited by 47 publications

References 20 publications

Bilateral Gigantomastia, Multiple Synchronous Nodular Pseudoangiomatous Stromal Hyperplasia Involving Breast and Bilateral Axillary Accessory Breast Tissue, and Perianal Mammary-Type Hamartoma of Anogenital Mammary-Like Glands

Bilateral Gigantomastia, Multiple Synchronous Nodular Pseudoangiomatous Stromal Hyperplasia Involving Breast and Bilateral Axillary Accessory Breast Tissue, and Perianal Mammary-Type Hamartoma of Anogenital Mammary-Like Glands

Giant pseudoangiomatous stromal hyperplasia presenting in the breast of a prepubertal child

Nodule-Forming Pseudoangiomatous Stromal Hyperplasia of the Breast: Report of Three Cases

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