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...
References and Further Reading
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.
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.
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.
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.
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.
Ibrahim, R. E., Sciotto, C. G., & Weidner, N. (1989). Pseudoangiomatous hyperplasia of mammary stroma. Some observations regarding its clinicopathologic spectrum. Cancer, 63, 1154–1160.
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.
Krings, G., McIntire, P., & Shin, S. J. (2017). Myofibroblastic, fibroblastic and myoid lesions of the breast. Seminars in Diagnostic Pathology, 34, 427–437.
Lee, J. S., Oh, H. S., & Min, K. W. (2005). Mammary pseudoangiomatous stromal hyperplasia presenting as an axillary mass. The Breast, 14, 61–64.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Rosen, P. P. (2001). Rosen’s breast pathology. Philadelphia: Lippincott Williams & Wilkins.
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.
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.
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.
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.
Virk, R. K., & Khan, A. (2010). Pseudoangiomatous stromal hyperplasia. An overview. Archives of Pathology and Laboratory Medicine, 134, 1070–1074.
Vuitch, M. F., Rosen, P. P., & Erlandson, R. A. (1986). Pseudoangiomatous hyperplasia of mammary stroma. Human Pathology, 17, 185–191.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Switzerland AG
About this entry
Cite this entry
Kulka, J., Sapino, A. (2019). Pseudoangiomatous Stromal Hyperplasia. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_4728-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-28845-1_4728-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-28845-1
Online ISBN: 978-3-319-28845-1
eBook Packages: Springer Reference MedicineReference Module Medicine