Pseudoangiomatous stromal hyperplasia of the breast.
ABSTRACT Pseudoangiomatous stromal hyperplasia is a relatively common lesion of the breast. In general, it is less commonly found as a clinically palpable mass and is more commonly found as incidental microscopic foci. It is a benign proliferative, probably neoplastic, hormonally driven process of the mammary stromal myofibroblasts. The clinical, radiologic, and cytologic findings can resemble those of fibroadenoma. Histologically, it can be confused with low-grade angiosarcoma. The exact etiology of pseudoangiomatous stromal hyperplasia is still controversial, but a neoplastic process of the stromal myofibroblasts, with a hormonal stimulus in its development and progression, is the favored theory. Most lesions can be cured by complete surgical excision, and patients undergoing the excision have a good prognosis.
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ABSTRACT: Compared to epithelial lesions, spindle-cell lesions of the breast are relatively uncommon and, because of that, may cause diagnostic difficulty. The majority of these spindle cell lesions, such as fibromatosis, nodular fasciitis, spindle-cell carcinoma, inflammatory myofibroblatic tumor and angiosarcoma, resemble their more common non-mammary counterparts. A few others, such as pseudoangiomatous stromal hyperplasia for example, specifically arise in breast. This review discusses these mammary spindle cell lesions with a focus on their salient histological features.The Open Breast Cancer Journal 05/2014; 4(1). DOI:10.2174/1876817201002011095
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ABSTRACT: Background Current literature provides controversies about the need for histologic examination of breast tissue that is excised for gynecomastia in adolescent males. We intended to analyze the histopathologic findings from a large series of juvenile and adolescents treated for gynecomastia. Methods Following the design of a retrospective chart review, data of all patients at the age of 21 or younger undergoing surgery for gynecomastia between January 1986 and December 2010 at a large Austrian State Hospital were obtained in an anonymized pattern. Results A total of 72 out of 380 patients (19 %) involved juvenile and adolescent males undergoing subcutaneous mastectomy diagnosed for gynecomastia. The histologic examination revealed true fibrotic gynecomastia in 85 %. True fibrotic gynecomastia in combination with PASH was found in 10 % of all cases. Conclusions Based on the various pathological histologic findings in our sample, we emphasize the routine histological sampling after surgical excision of breast tissue in gynecomastia to avoid the potential for overlooking pathologies. In view of the prevalence of true gynecomastia combined with PASH, surgeons have to be aware of this entity that is indeed benign with good prognosis but can be misdiagnosed as fibroadenoma or even angiosarcoma.European Surgery 08/2013; 45(4). DOI:10.1007/s10353-013-0220-1 · 0.26 Impact Factor
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ABSTRACT: The authors describe a 52-year-old woman with a history of bilateral mastectomies for macromastia caused by massive nodular pseudoangiomatous stromal hyperplasia (PASH), who presented with 2 large growths in her left axilla and groin. These masses had been increasing in size for nearly a year. When excised, the axillary mass had dimensions of 14.0 × 14.0 × 5.5 cm(3) and weighed 664 g. The groin mass was slightly smaller at 14.5 × 11.0 × 5.0 cm(3) and 518 g. Microscopic examination of both masses revealed breast tissue expanded by a hyalinized stroma with prominent slit-like pseudovascular spaces, consistent with PASH. Small incidental foci of PASH are common findings in breast excisions; however, large nodular foci are rare. Furthermore, nodular foci in accessory breast tissue are exceedingly rarer and can raise clinical concerns for malignancy. Histopathologically, PASH can be mistaken for low-grade angiosarcoma. To the authors' knowledge, the present case appears to be the first description of multiple simultaneous foci of massive nodular PASH arising in accessory breast tissue.International Journal of Surgical Pathology 02/2011; 19(1):113-6. DOI:10.1177/1066896910382006 · 0.96 Impact Factor