Encyclopedia of Pathology

Living Edition
| Editors: J.H.J.M. van Krieken

Pseudoangiomatous Stromal Hyperplasia

  • Janina KulkaEmail author
  • Anna Sapino
Living reference work entry
DOI: https://doi.org/10.1007/978-3-319-28845-1_4728-1

Synonyms

Nodular myofibroblastic stromal hyperplasia of the mammary gland (Leon et al. 2002).

Definition

Pseudoangiomatous hyperplasia of mammary stroma (PASH) is a benign proliferation of keloid-like fibrosis, containing slit-like pseudovascular spaces lined by spindle shaped cells without mitotic figures and atypia. (Ibrahim et al. 1989). PASH is considered a breast-specific myofibroblastic proliferation (Krings et al. 2017.

Clinical Features

  • Incidence

    PASH of the breast was first described by Vuitch et al. in 1986 (Vuitch et al. 1986). Its incidence was later investigated in a series of 200 consecutive breast biopsies and surgical specimens and was found to be an incidental finding in breast biopsies in 23% of the cases (Ibrahim et al. 1989). Incidental PASH can be found in fibroadenomas, gynecomastia, normal breast tissue, hamartomas, and sclerosing lobular hyperplasia. It has also been described in surgical specimens of gigantomastia. Two cases were described in immunosuppressed...

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References and Further Reading

  1. Bowman, E., Oprea, G., Okoli, J., Gundry, K., Rizzo, M., Gabram-Mendola, S., Manne, U., Smith, G., Pambuccian, S., & Bumpers, H. L. (2012). Pseudoangiomatous stromal hyperplasia (PASH) of the breast: A series of 24 patients. The Breast Journal, 18, 242–247.CrossRefGoogle Scholar
  2. Comunoğlu, N., Comunoğlu, C., Ilvan, S., Calay, Z., & Müslümanoğlu, M. (2007). Mammary Pseudoangiomatous stromal hyperplasia composed of predominantly Giant cells: An unusual variant. The Breast Journal, 13, 568–570.CrossRefGoogle Scholar
  3. Damiani, S., & Eusebi, V. (2001). Gynecomastia in type-1 neurofibromatosis with features of pseudoangiomatous stromal hyperplasia with giant cells. Report of two cases. Virchows Archiv, 438, 513–516.CrossRefGoogle Scholar
  4. de Saint Aubain Somerhausen, N., Larsimont, D., Cluydts, N., Heymans, O., & Verhest, A. (1997). Pseudoangiomatous hyperplasia of mammary stroma in an HIV patient. General & Diagnostic Pathology, 143, 251–254.Google Scholar
  5. Ferreira, M., Albarracin, C. T., & Resetkova, E. (2008). Pseudoangiomatous stromal hyperplasia tumor: A clinical, radiologic and pathologic study of 26 cases. Modern Pathology, 21, 201–207.CrossRefGoogle Scholar
  6. Ibrahim, R. E., Sciotto, C. G., & Weidner, N. (1989). Pseudoangiomatous hyperplasia of mammary stroma. Some observations regarding its clinicopathologic spectrum. Cancer, 63, 1154–1160.CrossRefGoogle Scholar
  7. Krawczyk, N., Fehm, T., Ruckhäberle, E., Mohrmann, S.,· Riemer, J. Braunstein, S. Hoffmann, J. (2016) Bilateral diffuse Pseudoangiomatous stromal hyperplasia (PASH) causing Gigantomastia in a 33-year-old pregnant woman: Case report. Breast Care, 11, 356–358.CrossRefGoogle Scholar
  8. Krings, G., McIntire, P., & Shin, S. J. (2017). Myofibroblastic, fibroblastic and myoid lesions of the breast. Seminars in Diagnostic Pathology, 34, 427–437.CrossRefGoogle Scholar
  9. Lee, J. S., Oh, H. S., & Min, K. W. (2005). Mammary pseudoangiomatous stromal hyperplasia presenting as an axillary mass. The Breast, 14, 61–64.CrossRefGoogle Scholar
  10. Leon, M. E., Leon, M. A., Ahuja, J., & Garcia, F. U. (2002). Nodular myofibroblastic stromal hyperplasia of the mammary gland as an accurate name for pseudoangiomatous stromal hyperplasia of the mammary gland. The Breast Journal, 8, 290–293.CrossRefGoogle Scholar
  11. Malik, D., Basher, R. K., Mittal, B. R., Jain, T. K., Bal, A., & Singh, S. K. (2017). 68Ga-PSMA expression in Pseudoangiomatous stromal hyperplasia of the breast. Clinical Nuclear Medicine, 42, 58–60.CrossRefGoogle Scholar
  12. Milanezi, M. F., Saggioro, F. P., Zanati, S. G., Bazan, R., & Schmitt, F. C. (1998). Pseudoangiomatous hyperplasia of mammary stroma associated with gynaecomastia. Journal of Clinical Pathology, 51, 204–206.CrossRefGoogle Scholar
  13. Nassar, H., Elieff, M. L., Kronz, J. D., & Argani, P. (2010). Pseudoangiomatous stromal hyperplasia (PASH) of the breast with focal of morphologic malignancy: A case of PASH with malignant transformation? International Journal of Surgical Pathology, 18, 564–569.CrossRefGoogle Scholar
  14. Noda, Y., Nishimae, A., Sawai, Y., Inaji, H., & Yamasaki, M. (2019). Atypical pseudoangiomatous stromal hyperplasia showing rapid growth of the breast: Report of a case. Pathology International.  https://doi.org/10.1111/pin.12786.
  15. Pellini, D. F., Lorenzi, M., Gaudino, R., Accordini, B., Mirandola, S., Invento, A., & Pollini, P. D. (2018). Pseudoangiomatous stromal hyperplasia (PASH) in adolescence: A systematic review. World Journal of Surgery and Surgical Research, 1, 1058.Google Scholar
  16. Polger, M. R., Denison, C. M., Lester, S., & Meyer, J. E. (1996). Pseudoangiomatous stromal hyperplasia: Mammographic and sonographic appearances. American Journal of Roentgenology, 166, 349–352.CrossRefGoogle Scholar
  17. Powell, C. M., Cranor, M. L., & Rosen, P. P. (1995). Pseudoangiomatous stromal hyperplasia (PASH): A mammary stromal tumor with myofibroblastic differentiation. American Journal of Surgical Pathology, 19, 270–277.CrossRefGoogle Scholar
  18. Pruthi, S., Reynolds, C., Johnson, R. E., & Gisvold, J. J. (2001). Tamoxifen in the management of Pseudoangiomatous stromal hyperplasia. The Breast Journal, 7, 434–439.CrossRefGoogle Scholar
  19. Raj, S. D., Sahani, V. G., Adrada, B. E., Scoggins, M. E., Albarracin, C. T., Woodtichartpreecha, P., Posleman Monetto, F. E., & Whitman, G. J. (2017). Pseudoangiomatous stromal hyperplasia of the breast: Multimodality review with pathologic correlation. Current Problems in Diagnostic Radiology, 46, 130–135.CrossRefGoogle Scholar
  20. Recavarren R. A., Chivukula M., Carter G., Dabbs D. J. (2009). Columnar cell lesions and pseudoangiomatous hyperplasia like stroma: is there an epithelial-stromal interaction? International Journal of Clinical and Experimental Pathology, 3, 87–97.Google Scholar
  21. Rosen, P. P. (2001). Rosen’s breast pathology. Philadelphia: Lippincott Williams & Wilkins.Google Scholar
  22. Roy, M., Lee, J., Aldekhayel, S., & Dionisopoulos, T. (2015). Pseudoangiomatous stromal hyperplasia: A rare cause of idiopathic Gigantomastia. Plastic and Reconstructive Surgery. Global Open, 3, e501.CrossRefGoogle Scholar
  23. Sasaki, Y., Kamata, S., Saito, K., Nishikawa, Y., & Ogawa, J. (2008). Pseudoangiomatous stromal hyperplasia (PASH) of the mammary gland: Report of a case. Surgery Today, 38, 340–343.CrossRefGoogle Scholar
  24. Seidman, J. D., Borkowski, A., Aisner, S. C., & Sun, C. C. (1993). Rapid growth of pseudoangiomatous hyperplasia of mammary stroma in axillary gynecomastia in an immunosuppressed patient. Archives of Pathology and Laboratory Medicine, 117, 736–738.PubMedGoogle Scholar
  25. Shahi, K. S., Bhandari, G., Gupta, R. K., & Sawai, M. (2015). Pseudoangiomatous stromal hyperplasia: A rare tumor of the breast. Journal of Cancer Research and Therapy, 11, 1032.CrossRefGoogle Scholar
  26. Virk, R. K., & Khan, A. (2010). Pseudoangiomatous stromal hyperplasia. An overview. Archives of Pathology and Laboratory Medicine, 134, 1070–1074.PubMedGoogle Scholar
  27. Vuitch, M. F., Rosen, P. P., & Erlandson, R. A. (1986). Pseudoangiomatous hyperplasia of mammary stroma. Human Pathology, 17, 185–191.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.2nd Department of PathologySemmelweis UniversityBudapestHungary
  2. 2.Unit of PathologyCandiolo Cancer Institute FPO-IRCCSCandioloItaly
  3. 3.Department of Medical SciencesUniversity of TorinoTurinItaly