Limits...
Bilateral diffuse tumorous pseudoangiomatous stromal hyperplasia: a case of bilateral mastectomy in a 29-year-old woman.

Dai H, Connor C, Cui W, Gatewood J, Fan F - Case Rep Pathol (2014)

Bottom Line: Microscopic evaluation of the nodules confirmed the diagnosis of PASH.No evidence of malignancy was identified.Recognition of this rare form of PASH is essential for the proper clinical management.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.

ABSTRACT
Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast lesion commonly encountered as an incidental microscopic finding. However, it can also manifest as a mass-forming lesion (tumorous PASH) capable of recurrence after surgical excision. Most of the previously reported cases of tumorous PASH present as a single dominant mass. Here we reported a rare case of diffuse tumorous PASH involving bilateral breasts clinically mimicking malignancy. A 29-year-old African-American female presented with a one-year history of bilateral breast enlargement and asymmetry. Physical examination revealed multiple palpable nodules in bilateral breasts. Imaging studies demonstrated innumerable homogeneously enhancing masses throughout both breasts, greater on the left, with multiple cysts and edema. Biopsy of the breast nodules demonstrated histopathological changes consistent with PASH. Due to the extent of the lesions and progressive clinical symptoms, decision was made to perform bilateral mastectomy. Macroscopic examination of the bilateral mastectomy specimens revealed markedly enlarged breasts with marked edema and numerous well-defined firm nodules. Microscopic evaluation of the nodules confirmed the diagnosis of PASH. No evidence of malignancy was identified. Recognition of this rare form of PASH is essential for the proper clinical management.

No MeSH data available.


Related in: MedlinePlus

Morphological features of the breast nodules (hematoxylin-eosin stain). Characteristic features of PASH including dense eosinophilic stroma and slit-like spaces lined by attenuated spindle cells are evident (original magnifications ×100 (a) and ×200 (b)).
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC4269278&req=5

fig3: Morphological features of the breast nodules (hematoxylin-eosin stain). Characteristic features of PASH including dense eosinophilic stroma and slit-like spaces lined by attenuated spindle cells are evident (original magnifications ×100 (a) and ×200 (b)).

Mentions: Left total mastectomy specimen weighed 1770 grams and measured 25.0 × 20.0 × 7.1 cm. Serial sectioning revealed diffuse nodularity, marked edema, and multiple cysts filled with clear fluid (Figure 2). The nodules were rubbery, gray/white in color, and relatively well-circumscribed, with the size of these nodules ranging from 9.0 × 2.7 × 2.0 cm to 0.5 × 0.5 × 0.3 cm. Right total mastectomy specimen weighed 1001 grams and measured 23.0 × 16.8 × 5.2 cm. Serial sectioning of the right breast revealed similar findings. Microscopic examination of the bilateral mammary tissue showed characteristic changes of PASH including stromal hyperplasia and bland spindle cell-lined slit-like open spaces (Figure 3). Additionally, marked stromal edema, dilated lymphatic channels, and mild lymphoplasmacytic infiltrate were also present. Immunohistochemical staining showed that the stromal cells were positive for estrogen receptor (ER) and progesterone receptor (PR) and negative for CD31, supporting the diagnosis of PASH.


Bilateral diffuse tumorous pseudoangiomatous stromal hyperplasia: a case of bilateral mastectomy in a 29-year-old woman.

Dai H, Connor C, Cui W, Gatewood J, Fan F - Case Rep Pathol (2014)

Morphological features of the breast nodules (hematoxylin-eosin stain). Characteristic features of PASH including dense eosinophilic stroma and slit-like spaces lined by attenuated spindle cells are evident (original magnifications ×100 (a) and ×200 (b)).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4269278&req=5

fig3: Morphological features of the breast nodules (hematoxylin-eosin stain). Characteristic features of PASH including dense eosinophilic stroma and slit-like spaces lined by attenuated spindle cells are evident (original magnifications ×100 (a) and ×200 (b)).
Mentions: Left total mastectomy specimen weighed 1770 grams and measured 25.0 × 20.0 × 7.1 cm. Serial sectioning revealed diffuse nodularity, marked edema, and multiple cysts filled with clear fluid (Figure 2). The nodules were rubbery, gray/white in color, and relatively well-circumscribed, with the size of these nodules ranging from 9.0 × 2.7 × 2.0 cm to 0.5 × 0.5 × 0.3 cm. Right total mastectomy specimen weighed 1001 grams and measured 23.0 × 16.8 × 5.2 cm. Serial sectioning of the right breast revealed similar findings. Microscopic examination of the bilateral mammary tissue showed characteristic changes of PASH including stromal hyperplasia and bland spindle cell-lined slit-like open spaces (Figure 3). Additionally, marked stromal edema, dilated lymphatic channels, and mild lymphoplasmacytic infiltrate were also present. Immunohistochemical staining showed that the stromal cells were positive for estrogen receptor (ER) and progesterone receptor (PR) and negative for CD31, supporting the diagnosis of PASH.

Bottom Line: Microscopic evaluation of the nodules confirmed the diagnosis of PASH.No evidence of malignancy was identified.Recognition of this rare form of PASH is essential for the proper clinical management.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.

ABSTRACT
Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast lesion commonly encountered as an incidental microscopic finding. However, it can also manifest as a mass-forming lesion (tumorous PASH) capable of recurrence after surgical excision. Most of the previously reported cases of tumorous PASH present as a single dominant mass. Here we reported a rare case of diffuse tumorous PASH involving bilateral breasts clinically mimicking malignancy. A 29-year-old African-American female presented with a one-year history of bilateral breast enlargement and asymmetry. Physical examination revealed multiple palpable nodules in bilateral breasts. Imaging studies demonstrated innumerable homogeneously enhancing masses throughout both breasts, greater on the left, with multiple cysts and edema. Biopsy of the breast nodules demonstrated histopathological changes consistent with PASH. Due to the extent of the lesions and progressive clinical symptoms, decision was made to perform bilateral mastectomy. Macroscopic examination of the bilateral mastectomy specimens revealed markedly enlarged breasts with marked edema and numerous well-defined firm nodules. Microscopic evaluation of the nodules confirmed the diagnosis of PASH. No evidence of malignancy was identified. Recognition of this rare form of PASH is essential for the proper clinical management.

No MeSH data available.


Related in: MedlinePlus