N2 pseudoangiomatous stromal hyperplasia pash is a relatively uncommon histologic finding in breast specimens. Bilateral pseudoangiomatous stromal hyperplasia of the breast. Pseudoangiomatous stromal hyperplasia moose and doc. Here, we provide a case report of pash and an overview of its radiological features. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 tollfree. On histological examination, they found the masses to be composed of mammary stromal proliferations with complex anastomosing channels lined with slender spindle cells simulating vascular channels. Tamoxifen in the management of pseudoangiomatous stromal. The size of the lesion varies, but small microscopic pash is much more common than larger tumorous masses. It has an appearance similar to fibroadenomatoid changes.
Pseudoangiomatous stromal hyperplasia in lesions involving. Rare presentation of pseudoangiomatous stromal hyperplasia. Treatment of pseudoangiomatous stromal hyperplasia of the. Pseudoangiomatous stromal hyperplasia pash is a benign, relatively uncommon form of stromal mesenchymal overgrowth within breast tissue that derives from a possible hormonal etiology. Jul 14, 2016 pseudoangiomatous stromal hyperplasia pash is a type of noncancerous breast lesion. Benign lesion of complex, anastomosing, slitlike spaces, that are either acellular or composed of spindled cells. Introduction pseudoangiomatous stromal hyperplasia pash of the breasts was first described by vuitch 1986 as a benign stromal breast lesion, characterized histologically by the proliferation of mature fibroblasts and myofibroblasts with formation of slitlike lesions that simulate vascular channels 1.
The clinicopathologic spectrum of this disease entity can range from a focal nonsignificant microscopic finding to a dominant palpable breast mass. There are extremely rare reports of pash arising in accessory breast tissue. Pseudoangiomatous stromal hyperplasia pash is a rare, benign noncancerous breast lesion. Pseudoangiomatous stromal hyperplasia pash is a benign proliferative lesion of the mammary stromal with hormonal influence. Typical clinical presentation of pash mimic fibroadenoma which is small unilateral painless breast lesion, discovered histologically after lumpectomy. New symptomatic and screendetected lesions are discussed in the second edition and include.
The topic pseudoangiomatous hyperplasia of mammary stroma you are seeking is a synonym, or alternative name, or is closely related to the medical condition pseudoangiomatous stromal hyperplasia of breast. Pathology outlines pseudoangiomatous stromal hyperplasia. T1 tamoxifen in the management of pseudoangiomatous stromal hyperplasia. It is a rare condition and until a few years mainly described in pathological and surgical literature. If you have problems viewing pdf files, download the latest version of adobe reader.
Pseudoangiomatous stromal hyperplasia pash is an uncommon benign proliferative breast tumor composed of complex, anastomosing slitlike pseudovascular spaces, which are either acellular or lined by slender spindleshaped stromal cells. In this article, four cases are presented in series to illustrate the varying clinical presentations of pash at mammography and sonography, as well as the vastly differing age groups that can be affected. Pseudoangiomatous stromal hyperplasia pash, is an overgrowth of myofibroblastic cells in the breast. Occasional cases have been described in men, postmenopausal women, adolescents, and children. The tumoral form of pash commonly manifests as a single, circumscribed, palpable mass. Pseudoangiomatous stromal hyperplasia pash is an uncommon benign mesenchymal breast lesion. Pash can present as clinically mimicking various benign or malignant conditions. It typically affects women in the reproductive age group. Pseudoangiomatous stromal hyperplasia pash is a benign breast pathology, ranging from focal microscopic findings to clinical and mammographically evident masses, characterized by abnormal proliferation of the mammary stroma. Dec 20, 2018 how can pseudoangiomatous stromal hyperplasia of breast be prevented.
A case report, international journal of case reports in medicine, vol. For language access assistance, contact the ncats public information officer. Sahani, beatriz elena adrada, marion elizabeth scoggins, constance albarracin, piyanoot woodtichartpreecha, flavia e. These myofibroblasts line anastomosing, slitlike stromal spaces in a manner resembling angiomatous blood vessels. May 07, 2019 pseudoangiomatous stromal hyperplasia pash is a rare and benign breast lesion belonging to an informal group of benign stromal lesions, which include. Pseudoangiomatous stromal hyperplasia pash is a benign proliferative. Pseudoangiomatous stromal hyperplasia pash is a benign condition characterized by proliferation of interlobular stroma, which may manifest as a discrete palpable mass nodular pash or by multifocal pash, which may be found incidentally in benign or malignant breast biopsies. Benign prostatic hyperplasia with lower urinary tract symptoms. Pseudoangiomatous stromal hyperplasia pash is a benign localized fibrotic lesion in which clusters of spindle cells form cleftlike spaces, resembling ectatic vessels.
Pseudoangiomatous stromal hyperplasia also known by the name of pash. Pseudoangiomatous stromal hyperplasia is an uncommon mesenchymal breast neoplasm. The most common mammographic and sonographic finding is a circumscribed mass. It is usually discovered incidentally, during a screening mammography. Pseudoangiomatous stromal hyperplasia pash is a type of noncancerous breast lesion. Case report rare presentation of pseudoangiomatous. Since then there have been few reported cases of pash in the literature.
Pseudoangiomatous stromal hyperplasia pash is a benign breast mesenchymal lesion characterized by slitlike pseudovascular spaces lined by endotheliallike spindle cells in a dense collagenous breast stroma. Since then there have been few reported cases of pash in the. Breast nonmalignant pseudoangiomatous stromal hyperplasia. Pseudoangiomatous stromal hyperplasia presenting as a breast mass.
Pseudoangiomatous stromal hyperplasia presenting as rapidly. Pseudoangiomatous stromal hyperplasia pash is a benign breast condition of collagen proliferation. Health, general hyperplasia development and progression intermediate filament proteins muscle proteins progesterone stem. Some of these entities include radial scar, sclerosing adenosis, fibroadenoma, fat necrosis, and pseudoangiomatous stromal hyperplasia. Pseudoangiomatous stromal hyperplasia is a widely accepted term, but it does not reflect this entitys true histogenesis. It warrants thorough investigation in order to exclude more sinister pathology masquerading as this form of benign breast disease and can often be managed expectantly without the need for surgical intervention. Its clinical and radiological findings and optimal treatment are still not clear. The diagnostic significance is currently uncertain, but it appears to be benign. Pseudoangiomatous stromal hyperplasia pash is an alteration of breast stroma which is histologically characterized by a proliferation of myofibroblasts within sclerotic matrix. Pseudoangiomatous stromal hyperplasia pash is a rare and benign mesenchymal proliferative breast lesion. Silverman, in comprehensive cytopathology third edition, 2008. Nodular myofibroblastic stromal hyperplasia of the mammary gland. Pseudoangiomatous stromal hyperplasia pash of the breast is a pathology that is usually diagnosed by accident during pathological examination of other breast lesions.
Patients with tumorous pash generally present a slowgrowing breast mass. Pseudoangiomatous stromal hyperplasia radiology reference. Since prevention is generally not possible, it is important to be aware of the risk factors of breast lumps. Pseudoangiomatous stromal hyperplasia pash is a benign proliferation of mammary stroma mostly described as an incidental. Nowak, pseudoangiomatous stromal hyperplasia of the breast case reports of two. Jul 01, 2010 pseudoangiomatous stromal hyperplasia can affect persons in any age group, ranging from 12 to 75 years, but it occurs more commonly in premenopausal women. Breast fibroadenoma with pseudoangiomatous pashlike stroma. Pseudoangiomatous stromal hyperplasia pash was first described by vuitch, erlandson and rosen in 1986. A study of the mammographic and sonographic features. Breast pseudoangiomatous stromal hyperplasia during early childhood. Pseudoangiomatous stromal hyperplasia radiology case. Breast fibroadenoma with pseudoangiomatous pashlike. Dec 05, 2017 pseudoangiomatous stromal hyperplasia pash is a rare, benign noncancerous breast lesion. Analysis of the mammographic and sonographic features of pseudoangiomatous stromal hyperplasia.
Its appearance on mri is nonspecific, but it may present as clumped nonmasslike persistent enhancement on contrastenhanced imaging. It has an appearance similar to fibroadenomatoid changes the diagnostic significance is currently uncertain, but it appears to be benign. Pseudoangiomatous stromal hyperplasia pash is a benign lesion of the breast that may present as a clinical nodule or be found as an incidental finding. Pseudoangiomatous stromal hyperplasia of the breast. Hormonal factors contribute probably to this pathology, since the average age of patients has been reported to be 40 years and can occur in postmenopausal. May be a circumscribed mass or microscopic incidental finding. Pseudoangiomatous stromal hyperplasia genetic and rare. Pseudoangiomatous stromal hyperplasia pash of the breast is a benign, proliferative mesenchymal lesion with possible hormonal etiology. May 25, 2014 pseudoangiomatous stromal hyperplasia pash is a benign breast pathology, ranging from focal microscopic findings to clinical and mammographically evident masses, characterized by abnormal proliferation of the mammary stroma. All patients were females ages, 42, 43, and 53 years.
Pseudoangiomatous stromal hyperplasia pash is a benign condition. The etiologic factors of pash are unknown, but most investigators think that it represents a proliferative response of myofibroblasts, probably to hormonal stimuli. Pseudoangiomatous stromal hyperplasia pash in male patients is a. Its relationship to breast cancer risk has not been characterized. How to manage pseudoangiomatous stromal hyperplasia. Pseudoangiomatous stromal hyperplasia springerlink. Pseudoangiomatous hyperplasia of mammary stroma pash is a benign. Pseudoangiomatous stromal hyperplasia pash, first reported in 1986, is nowadays a wellrecognized change in the breast. Pseudoangiomatous stromal hyperplasia and breast cancer risk. The tumoral form of pseudoangiomatous stromal hyperplasia is rare. Pseudoangiomatous stromal hyperplasia is a benign mesenchymal tumor of the breast. Pseudoangiomatous stromal hyperplasia libre pathology. The first edition concentrated on screendetected lesions, which has been rectified.
Pseudoangiomatous stromal hyperplasia definition of. On histological examination, they found the masses to be composed of mammary stromal proliferations with complex anastomosing channels lined with slender spindle cells simulating. Pseudoangiomatous stromal hyperplasia of breast is difficult to prevent, because it is most likely caused by abnormal or fluctuating reproductive hormone levels. Pseudoangiomatous stromal hyperplasia, more commonly known as pash, is a wellrecognized but poorly understood entity. Pseudoangiomatous stromal hyperplasia pash is a benign entity of the breast. Celliers l, wong dd, bourke a 2010 pseudoangiomatous stromal hyperplasia.
When found as an incidental finding it may be referred to as the pash phenomenon. Breast pathology book, atypical pash appears to be myofibroblastic sarcoma. Pseudoangiomatous stromal hyperplasia pash is a relatively. There have been cases of pash diagnosed where the tumors coexist with breast cancer. Pseudoangiomatous stromal hyperplasia pash is a benign proliferative lesion of the breast stroma first described in 1986 by vuitch et al.
Know the causes and treatment of pseudoangiomatous stromal hyperplasia. To analyze the mammographic, ultrasonographic us, and clinical patterns of pseudoangiomatous stromal hyperplasia pash. Pseudoangiomatous stromal hyperplasia pash is a benign entity of the breast and typically found incidentally. Printable pseudoangiomatous stromal hyperplasia pash. Pseudoangiomatous stromal hyperplasia pash is a benign disease of the breast characterized by a complex network of slitlike spaces lined by slender spindle cells within a background of stromal hyperplasia figs. These myofibroblasts line anastomosing, slitlike stromal spaces in. Pseudoangiomatous stromal hyperplasia pash of the breast is a common microscopic lesion that is found at breast biopsy, and presents with proliferation of the stromal cells and slitlike. It can present as a dense mass which can only sometimes be felt when palpating the breast. Pseudoangiomatous stromal hyperplasia and breast cancer. Pseudoangiomatous stromal hyperplasia pash of breast is a rare, benign tumor of breast, which is observed in young and old women. Pseudoangiomatous stromal hyperplasia a benign and rare.
Pseudoangiomatous stromal hyperplasia an overview researchgate. Pseudoangiomatous stromal hyperplasia pathology outlines. Pseudoangiomatous stromal hyperplasia can be a difficult differential diagnosis at times because the radiological appearance of the lesion mimics that of breast fibroadenoma. Case report bilateral simultaneous pseudoangiomatous. Pseudoangiomatous stromal hyperplasia pash is a rare benign proliferating breast condition. Pseudoangiomatous stromal hyperplasia pash is a rare and benign breast lesion belonging to an informal group of benign stromal lesions, which include. Pseudoangiomatous stromal hyperplasia of the breast pash is a benign lesion of the mammary stroma that is relatively common in women of childbearing. Bilateral simultaneous pseudoangiomatous stromal hyperplasia. It is an extremely rare and benign pathological condition of the breasts in which there is development of palpable mass or lesions around the breasts. What is pseudoangiomatous stromal hyperplasia, know its. Pseudoangiomatous stromal hyperplasia pash of breast is a rare, benign tumor of breast, which is observed in young and old. It was first reported in 1986 when vuitch, rosen, and erlandson described nine cases of benign wellcircumscribed, breast masses that simulated vascular lesions consisting of mammary stromal proliferations vuitch et al.
Pseudoangiomatous stromal hyperplasia pash is a relatively uncommon histologic finding in breast specimens. Sep 15, 2015 pseudoangiomatous stromal hyperplasia pash is a benign proliferative lesion of the breast stroma first described in 1986 by vuitch et al. Pash is an uncommon and benign tumoral lesion of the mammary stroma that can be pathologically mistaken for other tumours, such as phyllodes, fibroadenoma, and sometimes even angiosarcoma. The exact mechanism of tissue proliferation is unknown, but there is evidence to suggest. Pseudoangiomatous stromal hyperplasia pash surgical. How can pseudoangiomatous stromal hyperplasia of breast be prevented. Request pdf pseudoangiomatous stromal hyperplasia an overview pseudoangiomatous stromal hyperplasia pash of the breast is a benign, proliferative mesenchymal lesion with possible hormonal.
Leon, ma ahuja, j garcia, fu nodular myofibroblastic stromal hyperplasia of the mammary gland as an accurate name for pseudoangiomatous stromal hyperplasia of the mammary gland. Bilateral diffuse pseudoangiomatous stromal hyperplasia pash. We present three cases of lesions involving anogenital mammarylike glands demonstrating this feature. Pseudoangiomatous stromal hyperplasia an overview request pdf.
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