Abstract:
UNASSIGNED: Pseudoangiomatous stromal hyperplasia (PASH) is a benign entity of the breast and typically found incidentally or as a palpable mass. It usually affects women in the reproductive age group. In men, it is associated with gynecomastia. While the exact etiology is unknown, PASH is considered hormonally responsive. The mammography and ultrasonography findings are nonspecific. Grossly, PASH is a well-circumscribed, firm, rubbery mass with solid, homogenous, gray-white cut surface. On histologic examination, it is characterized by the presence of open slit-like spaces in dense collagenous stroma. The spindle cells express progesterone receptors and are positive for vimentin, actin, and CD34. PASH lesions should be surgically excised if increasing in size or associated with symptoms, also in cases of suspicious imaging findings or other lesions are synchronously diagnosed that require excision. In other small incidentally detected asymptomatic cases observation with clinicoradiological follow-up can be considered. It is associated with a good prognosis with no increased risk to develop breast cancer. Hence, the operating surgeon and pathologist should be aware of this not so uncommon entity so that patients are not subjected to unnecessary excision and subsequent physical and mental morbidity associated with it. In this article, we present a case report and also provide a brief review of the sparse literature on PASH, discussing clinical presentation, etiology and pathogenesis, radiopathological features, differential diagnosis, and the implications for further patient management and prognosis.
摘要:
■假血管瘤性间质增生(PASH)是乳腺的良性实体,通常是偶然发现的或可触及的肿块。它通常影响育龄妇女。在男人中,它与男性乳房发育症有关。虽然确切的病因尚不清楚,PASH被认为是荷尔蒙反应。乳房X线照相术和超声检查结果无特异性。严重的,PASH是一个很好的限制,公司,具有固体的橡胶块,同质,灰白色切割表面。在组织学检查中,它的特征是在致密的胶原基质中存在开放的狭缝状空间。梭形细胞表达孕激素受体,波形蛋白阳性,肌动蛋白,CD34如果面积增大或与症状相关,则应手术切除PASH病变。此外,在可疑的影像学发现或其他病变的情况下,需要切除同步诊断。在其他少量偶然发现的无症状病例中,可以考虑进行临床放射随访。它与良好的预后相关,没有增加患乳腺癌的风险。因此,手术外科医生和病理学家应该意识到这个并不罕见的实体,这样患者就不会遭受不必要的切除以及随之而来的身体和精神疾病。在这篇文章中,我们提供了一个病例报告,并简要回顾了关于PASH的稀疏文献,讨论临床表现,病因和发病机制,放射病理学特征,鉴别诊断,以及对进一步患者管理和预后的影响。