Difference between revisions of "Pseudoangiomatous stromal hyperplasia"

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#redirect [[Breast_pathology#Pseudoangiomatous_stromal_hyperplasia]]
'''Pseudoangiomatous stromal hyperplasia''', abbreviated ''PASH'', is benign lesion is [[breast pathology]].


It is also known as '''nodular myofibroblastic stromal hyperplasia of the mammary gland'''.<ref name=pmid12199757>{{Cite journal  | last1 = Leon | first1 = ME. | last2 = Leon | first2 = MA. | last3 = Ahuja | first3 = J. | last4 = Garcia | first4 = FU. | title = Nodular myofibroblastic stromal hyperplasia of the mammary gland as an accurate name for pseudoangiomatous stromal hyperplasia of the mammary gland. | journal = Breast J | volume = 8 | issue = 5 | pages = 290-3 | month =  | year =  | doi =  | PMID = 12199757 }}</ref>
==General==
*Benign lesion.
*Thought to arise due to myofibroblast abnormality - though not well understood.<ref name=pmid7872425>{{cite journal |author=Powell CM, Cranor ML, Rosen PP |title=Pseudoangiomatous stromal hyperplasia (PASH). A mammary stromal tumor with myofibroblastic differentiation |journal=Am. J. Surg. Pathol. |volume=19 |issue=3 |pages=270–7 |year=1995 |month=March |pmid=7872425 |doi= |url=}}</ref>
==Gross==
Features:<ref name=pmid7872425>{{cite journal |author=Powell CM, Cranor ML, Rosen PP |title=Pseudoangiomatous stromal hyperplasia (PASH). A mammary stromal tumor with myofibroblastic differentiation |journal=Am. J. Surg. Pathol. |volume=19 |issue=3 |pages=270–7 |year=1995 |month=March |pmid=7872425 |doi= |url=}}</ref>
*May form mass: grey-white & firm, with well circumscribed borders.
==Microscopic==
Features:<ref name=pmid3949338>{{cite journal |author=Vuitch MF, Rosen PP, Erlandson RA |title=Pseudoangiomatous hyperplasia of mammary stroma |journal=Hum. Pathol. |volume=17 |issue=2 |pages=185–91 |year=1986 |month=February |pmid=3949338 |doi= |url=}}</ref><ref name=pmid18084246>{{Cite journal  | last1 = Ferreira | first1 = M. | last2 = Albarracin | first2 = CT. | last3 = Resetkova | first3 = E. | title = Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases. | journal = Mod Pathol | volume = 21 | issue = 2 | pages = 201-7 | month = Feb | year = 2008 | doi = 10.1038/modpathol.3801003 | PMID = 18084246 }}</ref>
*Abundant breast stromal.
*Small, complex, inter-anastomosing (blood vessel/capillary-like) channels - '''key feature'''.
**''Pseudoangiomatous'' = blood vessel-like.
Notes:
*May mimic angiosarcoma at low power; PASH may have the same architecture but lack nuclear atypia.
DDx:
*[[Angiosarcoma]].
*[[Fibroadenoma]].
===Images===
<gallery>
Image:Pseudoangiomatous_stromal_hyperplasia_-a-_low_mag.jpg | PASH - low mag. (WC/Nephron)
Image:Pseudoangiomatous_stromal_hyperplasia_-a-_intermed_mag.jpg | PASH - intermed. mag. (WC/Nephron)
Image:Pseudoangiomatous_stromal_hyperplasia_-_high_mag.jpg | PASH - high mag. (WC/Nephron)
</gallery>
www:
*[http://www.nature.com/modpathol/journal/v21/n2/fig_tab/3801003f1.html#figure-title PASH (nature.com)].<ref name=pmid18084246>{{Cite journal  | last1 = Ferreira | first1 = M. | last2 = Albarracin | first2 = CT. | last3 = Resetkova | first3 = E. | title = Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases. | journal = Mod Pathol | volume = 21 | issue = 2 | pages = 201-7 | month = Feb | year = 2008 | doi = 10.1038/modpathol.3801003 | PMID = 18084246 }}</ref>
==IHC==
Findings:<ref name=pmid7872425/>
*CD34 +ve.
*Vimentin +ve.
*Bcl-2 +ve.<ref name=pmid21843705/><ref>URL: [http://surgpathcriteria.stanford.edu/breast/pash/printable.html http://surgpathcriteria.stanford.edu/breast/pash/printable.html]. Accessed on: 28 April 2012.</ref>
*Factor VIII -ve.
*CD31 -ve.<ref name=pmid21843705>{{Cite journal  | last1 = Baker | first1 = M. | last2 = Chen | first2 = H. | last3 = Latchaw | first3 = L. | last4 = Memoli | first4 = V. | last5 = Ornvold | first5 = K. | title = Pseudoangiomatous stromal hyperplasia of the breast in a 10-year-old girl. | journal = J Pediatr Surg | volume = 46 | issue = 8 | pages = e27-31 | month = Aug | year = 2011 | doi = 10.1016/j.jpedsurg.2011.04.063 | PMID = 21843705 }}</ref>
==See also==
*[[Breast pathology]].
*[[Fibroadenoma]].
==References==
{{Reflist|2}}
[[Category:Breast pathology]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Revision as of 00:25, 1 February 2014

Pseudoangiomatous stromal hyperplasia, abbreviated PASH, is benign lesion is breast pathology.

It is also known as nodular myofibroblastic stromal hyperplasia of the mammary gland.[1]

General

  • Benign lesion.
  • Thought to arise due to myofibroblast abnormality - though not well understood.[2]

Gross

Features:[2]

  • May form mass: grey-white & firm, with well circumscribed borders.

Microscopic

Features:[3][4]

  • Abundant breast stromal.
  • Small, complex, inter-anastomosing (blood vessel/capillary-like) channels - key feature.
    • Pseudoangiomatous = blood vessel-like.

Notes:

  • May mimic angiosarcoma at low power; PASH may have the same architecture but lack nuclear atypia.

DDx:

Images

  • PASH - low mag. (WC/Nephron)

  • PASH - intermed. mag. (WC/Nephron)

  • PASH - high mag. (WC/Nephron)

www:

IHC

Findings:[2]

  • CD34 +ve.
  • Vimentin +ve.
  • Bcl-2 +ve.[5][6]
  • Factor VIII -ve.
  • CD31 -ve.[5]

See also

References

  1. ↑ Leon, ME.; Leon, MA.; Ahuja, J.; Garcia, FU.. "Nodular myofibroblastic stromal hyperplasia of the mammary gland as an accurate name for pseudoangiomatous stromal hyperplasia of the mammary gland.". Breast J 8 (5): 290-3. PMID 12199757.
  2. ↑ 2.0 2.1 2.2 Powell CM, Cranor ML, Rosen PP (March 1995). "Pseudoangiomatous stromal hyperplasia (PASH). A mammary stromal tumor with myofibroblastic differentiation". Am. J. Surg. Pathol. 19 (3): 270–7. PMID 7872425.
  3. ↑ Vuitch MF, Rosen PP, Erlandson RA (February 1986). "Pseudoangiomatous hyperplasia of mammary stroma". Hum. Pathol. 17 (2): 185–91. PMID 3949338.
  4. ↑ 4.0 4.1 Ferreira, M.; Albarracin, CT.; Resetkova, E. (Feb 2008). "Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases.". Mod Pathol 21 (2): 201-7. doi:10.1038/modpathol.3801003. PMID 18084246.
  5. ↑ 5.0 5.1 Baker, M.; Chen, H.; Latchaw, L.; Memoli, V.; Ornvold, K. (Aug 2011). "Pseudoangiomatous stromal hyperplasia of the breast in a 10-year-old girl.". J Pediatr Surg 46 (8): e27-31. doi:10.1016/j.jpedsurg.2011.04.063. PMID 21843705.
  6. ↑ URL: http://surgpathcriteria.stanford.edu/breast/pash/printable.html. Accessed on: 28 April 2012.
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