Download PDF
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2022; 32(04): 582-590
DOI: 10.1055/s-0042-1750174
Case Series

Radiological Spectrum of Pseudoangiomatous Stromal Hyperplasia of Breast—A Case Series

Prathiba Rajalakshmi Parameswaran
1   Division of Breast and Women's imaging and Interventions, Department of Diagnostic and Interventional Radiology, Kovai Medical Center and Hospitals, Coimbatore, Tamil Nadu, India
,
Rupa Renganathan 
1   Division of Breast and Women's imaging and Interventions, Department of Diagnostic and Interventional Radiology, Kovai Medical Center and Hospitals, Coimbatore, Tamil Nadu, India
,
Prema Subramaniam 
1   Division of Breast and Women's imaging and Interventions, Department of Diagnostic and Interventional Radiology, Kovai Medical Center and Hospitals, Coimbatore, Tamil Nadu, India
,
Vinita Thakur
1   Division of Breast and Women's imaging and Interventions, Department of Diagnostic and Interventional Radiology, Kovai Medical Center and Hospitals, Coimbatore, Tamil Nadu, India
› Author Affiliations Funding Nil.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal tumor-like lesion of the breast. It is commonly seen as incidental background changes of the intralobular stroma in biopsy specimens performed for other breast lesions. Less frequently, it presents as a nodular form that has a benign morphology on imaging, mimicking fibroadenoma or as a diffuse form causing progressive massive gigantomastia. Diagnosis is established by biopsy. Knowledge of the imaging appearance of PASH not only facilitates proper assessment of radiopathological correlation but also helps in deciding further management of these lesions. Occasionally, nodular PASH may have a suspicious appearance on imaging wherein excision biopsy is indicated to exclude a coexisting carcinoma.

Keywords

pseudoangiomatous stromal hyperplasia - nodular form - diffuse form - incidental PASH changes

Meeting Presentation

No.




Publication History

Article published online:
26 October 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Vuitch MF, Rosen PP, Erlandson RA. Pseudoangiomatous hyperplasia of mammary stroma. Hum Pathol 1986; 17 (02) 185-191
    CrossrefPubMedGoogle Scholar
  • 2 Estes A, Cao L, Miller ME. Pseudoangiomatous stromal hyperplasia: overview and clinical management. Ann Breast Surg 2020; 4: 22-36
    CrossrefGoogle Scholar
  • 3 Ibrahim RE, Sciotto CG, Weidner N. Pseudoangiomatous hyperplasia of mammary stroma. Some observations regarding its clinicopathologic spectrum. Cancer 1989; 63 (06) 1154-1160
    CrossrefPubMedGoogle Scholar
  • 4 Jaunoo SS, Thrush S, Dunn P. Pseudoangiomatous stromal hyperplasia (PASH): a brief review. Int J Surg 2011; 9 (01) 20-22
    CrossrefPubMedGoogle Scholar
  • 5 Ferreira M, Albarracin CT, Resetkova E. Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases. Mod Pathol 2008; 21 (02) 201-207
    CrossrefPubMedGoogle Scholar
  • 6 Kelten Talu C, Boyaci C, Leblebici C, Hacihasanoglu E, Bozkurt ER. Pseudoangiomatous stromal hyperplasia in core needle biopsies of breast specimens. Int J Surg Pathol 2017; 25 (01) 26-30
    CrossrefPubMedGoogle Scholar
  • 7 Drinka EK, Bargaje A, Erşahin ÇH. et al. Pseudoangiomatous stromal hyperplasia (PASH) of the breast: a clinicopathological study of 79 cases. Int J Surg Pathol 2012; 20 (01) 54-58
    CrossrefPubMedGoogle Scholar
  • 8 Degnim AC, Frost MH, Radisky DC. et al. Pseudoangiomatous stromal hyperplasia and breast cancer risk. Ann Surg Oncol 2010; 17 (12) 3269-3277
    CrossrefPubMedGoogle Scholar
  • 9 Milanezi MF, Saggioro FP, Zanati SG, Bazan R, Schmitt FC. Pseudoangiomatous hyperplasia of mammary stroma associated with gynaecomastia. J Clin Pathol 1998; 51 (03) 204-206
    CrossrefPubMedGoogle Scholar
  • 10 Polger MR, Denison CM, Lester S, Meyer JE. Pseudoangiomatous stromal hyperplasia: mammographic and sonographic appearances. AJR Am J Roentgenol 1996; 166 (02) 349-352
    CrossrefPubMedGoogle Scholar
  • 11 Celliers L, Wong DD, Bourke A. Pseudoangiomatous stromal hyperplasia: a study of the mammographic and sonographic features. Clin Radiol 2010; 65 (02) 145-149
    CrossrefPubMedGoogle Scholar
  • 12 Jones KN, Glazebrook KN, Reynolds C. Pseudoangiomatous stromal hyperplasia: imaging findings with pathologic and clinical correlation. AJR Am J Roentgenol 2010; 195 (04) 1036-1042
    CrossrefPubMedGoogle Scholar
  • 13 Raj SD, Sahani VG, Adrada BE. et al. Pseudoangiomatous stromal hyperplasia of the breast: multimodality review with pathologic correlation. Curr Probl Diagn Radiol 2017; 46 (02) 130-135
    CrossrefPubMedGoogle Scholar
  • 14 Lee SJ, Mahoney MC. Benign findings in breast MRI. In: Molleran V. ed. Breast MRI. Philadelphia: Elsevier Saunders; 2014: 62-92
    Google Scholar
  • 15 Ryu EM, Whang IY, Chang ED. Rapidly growing bilateral pseudoangiomatous stromal hyperplasia of the breast. Korean J Radiol 2010; 11 (03) 355-358
    CrossrefPubMedGoogle Scholar
  • 16 Teh HS, Chiang SH, Leung JW, Tan SM, Mancer JF. Rapidly enlarging tumoral pseudoangiomatous stromal hyperplasia in a 15-year-old patient: distinguishing sonographic and magnetic resonance imaging findings and correlation with histologic findings. J Ultrasound Med 2007; 26 (08) 1101-1106
    CrossrefPubMedGoogle Scholar
  • 17 Solomou E, Kraniotis P, Patriarcheas G. A case of a giant pseudoangiomatous stromal hyperplasia of the breast: magnetic resonance imaging findings. Rare Tumors 2012; 4 (02) e23
    CrossrefPubMedGoogle Scholar
  • 18 Krawczyk N, Fehm T, Ruckhäberle E. et al. Bilateral diffuse pseudoangiomatous stromal hyperplasia (PASH) causing gigantomastia in a 33-year-old pregnant woman: case report. Breast Care (Basel) 2016; 11 (05) 356-358
    CrossrefPubMedGoogle Scholar
  • 19 Dai H, Connor C, Cui W, Gatewood J, Fan F. Bilateral diffuse tumorous pseudoangiomatous stromal hyperplasia: a case of bilateral mastectomy in a 29-year-old woman. Case Rep Pathol 2014; 2014: 250608
    PubMedGoogle Scholar