Immunocytochemical Analysis of Estrogen and Progesterone Receptors in Benign Stromal Lesions of the Breast

Anderson, C. Russell; Ricci, Andrew; Pedersen, Carl A.; Cartun, Richard W.

doi:10.1097/00000478-199102000-00007

Cited by 146 publications

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“…The stromal cells in pseudoangiomatous stromal hyperplasia lesions have been found to be progesterone receptor positive, 11 and similarities have been found between pseudoangiomatous stromal hyperplasia and features of intralobular stroma during the luteal phase of the menstrual cycle; 12 these findings support the hypothesis that pseudoangiomatous stromal hyperplasia is a hormone-related proliferation of intralobular stromal cells. [1][2][3]6,11 We did not evaluate hormone receptors in pseudoangiomatous stromal hyperplasia tumors in our series, except one instance of pseudoangiomatous stromal hyperplasia tumor with concomitant invasive carcinoma, where we noticed a strong positivity of stromal cells of pseudoangiomatous stromal hyperplasia for progesterone receptor. Most pseudoangiomatous stromal hyperplasia tumors mimic fibroadenomas or hamartomas on imaging and they are often described as welldefined masses on mammography [8][9][10] and wellcircumscribed hypoechoic lesions on sonography.…”

Section: Discussionsupporting

confidence: 56%

Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases

Ferreira¹,

2008

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Pseudoangiomatous stromal hyperplasia tumors are rare. In this retrospective study, we evaluated the clinical, radiologic, and pathologic features of pseudoangiomatous stromal hyperplasia tumors and compared histologic findings of pseudoangiomatous stromal hyperplasia tumors with clinical outcome. We identified 26 patients (mean age, 47 years) with pseudoangiomatous stromal hyperplasia tumors who had been diagnosed at our institution. Sixteen patients (62%) were premenopausal, and 13 (50%) had a history of oral contraceptive or hormone replacement therapy use. Ten patients (38%) presented with a palpable mass; in the other patients, the tumors were detected by mammography (where it usually appeared as a hyperdense mass with irregular margins) or sonography (where it usually appeared as a hypoechoic mass). Lesions were a mean of 4.2 cm at the largest dimension (range, 0.8-11 cm). Histologically, pseudoangiomatous stromal hyperplasia was classified as simple in 18 patients (69%) and fascicular/proliferative in eight patients (31%). In one patient (4%), an invasive ductal carcinoma was present within the pseudoangiomatous stromal hyperplasia tumor. We found associated benign epithelial lesions in eight patients (31%) and/or gynecomastia-like changes in 17 patients (65%). The presence of gynecomastia-like changes was significantly associated with intralobular location of pseudoangiomatous stromal hyperplasia (P ¼ 0.00085, by Fisher's exact test). Follow-up data were available for 15 patients (mean±s.d., r27±17 months). No additional pathology or substantial changes in existing lesions were found on imaging. All pseudoangiomatous stromal hyperplasia tumors diagnosed by core needle biopsy but not subsequently excised remained clinically and radiologically stable; therefore, offering the option of close clinical surveillance instead of surgery in patients with pseudoangiomatous stromal hyperplasia tumors diagnosed by core needle biopsy in selected patients.

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Section: Discussionsupporting

confidence: 56%

Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases

Ferreira¹,

2008

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“…PASH has also been described in men with gynecomastia and a trans-sexual patient taking exogenous hormones (7,8). Furthermore, immuohistochemical positivity for the progesterone hormone receptor has been observed in stromal cells (6). Two of three patients were premenopausal in this report and showed immunopositivity for the progesterone receptor.…”

Section: Discussionsupporting

confidence: 64%

“…Kelten et al Pseudoangiomatous Stromal Hyperplasia replacement treatment (6). PASH has also been described in men with gynecomastia and a trans-sexual patient taking exogenous hormones (7,8).…”

Section: Discussionmentioning

confidence: 99%

Nodule-Forming Pseudoangiomatous Stromal Hyperplasia of the Breast: Report of Three Cases

Kelten¹,

Boyacı²,

Leblebıcı³

et al. 2015

J Breasth Health

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Pseudoangiomatous stromal hyperplasia (PASH) is a benign proliferative entity of mammary stroma. It is generally found as an incidental finding. It may rarely present as a palpable nodule. Three patients, who were 29, 45, and 58 years of age, were referred to our clinic with nodule and pain in the breast. The physical examinations and ultrasound findings of all three patients were consistent with fibroadenoma. Core biopsies were performed and reported as "benign breast parenchyma including stromal fibrosis." PASH areas were noted in one case. The excision specimens were observed as solid nodular masses with smooth external surfaces and white in colour. Microscopically, well-demarcated hyalinized stroma, including slit-like pseudovascular spaces lined by bland spindle cells, was observed. Immunohistochemically, these cells showed positive staining for CD34 and negative staining for CD31. Nodule-forming PASH mostly confuses with fibroadenoma with respect to clinical examination and radiological findings. Definite diagnosis requires histopathological verification. Differential diagnosis should be made with low grade angiosarcoma, fibroepithelial tumors, and myofibroblastoma.

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“…1 These clinical observations were initially substantiated by early experiments in the 1980s using radioligand assays, which confirmed the presence of the estrogen receptor (ER) in vascular tumors; 2,3 however, with the advent of immunohistochemical techniques, subsequent studies performed in the 1990s with antibodies raised against the ER refuted these earlier data and it appeared that the newer technology had exposed the limitations of the older biochemical assays. [4][5][6][7] Recently, an additional ER subtype, estrogen receptor beta (ERb), 8 was identified and the previous ER against which the original antibodies were raised was renamed estrogen receptor alpha (ERa). Although ERa has been assessed immunohistochemically in vascular neoplasms and found to be absent, ERb has not been previously characterized in these entities.…”

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confidence: 99%

Estrogen receptor β expression in vascular neoplasia: an analysis of 53 benign and malignant cases

et al. 2004

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The importance of estrogen in vascular neoplasia is suggested by a predilection for women and a tendency for rapid growth during pregnancy. Although early experiments using radioligand assays demonstrated estrogen receptor (ER) expression, these findings were not confirmed by subsequent immunohistochemical studies which were performed with antibodies raised against ERa. A newly discovered estrogen receptor subtype, ERb, has not been previously characterized in vascular lesions. In order to verify the expression of estrogen receptors in vascular neoplasms as well as to clarify the inconsistency between radioligand and early immunohistochemical studies, we examined a series of 53 benign and malignant vascular neoplasms for ERb expression. All of the subtypes of vascular neoplasia examined had nuclear expression of ERb. The majority of cases (94%) displayed 2 þ to 3 þ staining. The discrepancy between radioligand studies and previous immunohistochemical studies is attributable to the use of antibodies raised against ERa, which is not expressed in vascular lesions, and not ERb, which is broadly expressed in both benign and malignant vascular neoplasms. Although ERb may be of limited diagnostic use in vascular neoplasia due to its broad expression, the potential exists for a therapeutic approach using ER agonists. The role of estrogen in vascular neoplasia has long been suspected due to the observation that vascular neoplasms tend to grow rapidly during pregnancy and in adolescence. 1 These clinical observations were initially substantiated by early experiments in the 1980s using radioligand assays, which confirmed the presence of the estrogen receptor (ER) in vascular tumors; 2,3 however, with the advent of immunohistochemical techniques, subsequent studies performed in the 1990s with antibodies raised against the ER refuted these earlier data and it appeared that the newer technology had exposed the limitations of the older biochemical assays. [4][5][6][7] Recently, an additional ER subtype, estrogen receptor beta (ERb), 8 was identified and the previous ER against which the original antibodies were raised was renamed estrogen receptor alpha (ERa). Although ERa has been assessed immunohistochemically in vascular neoplasms and found to be absent, ERb has not been previously characterized in these entities. In order to verify the expression of ER in vascular tumors as well as to clarify the inconsistency between radioligand and early immunohistochemical studies, we examined a series of 53 benign and malignant vascular neoplasms for ERb expression. Materials and methodsIn all, 22 cases of angiosarcoma, three cases of Kaposi sarcoma, one case of epithelioid hemangioendothelioma, two cases of spindle-cell hemangioma, four cases of infantile hemangioendothelioma, 13 cases of hemangioma, seven cases of lymphangioma and one case of papillary endothelial hyperplasia were identified and retrieved from the paraffin archives of the University of Chicago. Formalin-fixed paraffin-embedded specimens were cut into 4-mm sections an...

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Immunocytochemical Analysis of Estrogen and Progesterone Receptors in Benign Stromal Lesions of the Breast

Cited by 146 publications

References 0 publications

Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases

Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases

Nodule-Forming Pseudoangiomatous Stromal Hyperplasia of the Breast: Report of Three Cases

Estrogen receptor β expression in vascular neoplasia: an analysis of 53 benign and malignant cases

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