Pseudoangiomatous hyperplasia of mammary stroma

Vuitch, Milan F.; Rosen, Paul Peter; Erlandson, Robert A.

doi:10.1016/s0046-8177(86)80292-1

Cited by 290 publications

(294 citation statements)

References 10 publications

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“…7,9 Rates of lesion growth, as demonstrated by consecutive imaging, have been reported to be 0-71.4%. 1,9 In one patient in our study, the lesion grew during the 27-month follow-up period, prompting a subsequent surgical resection. No disease recurrence was reported in the 10 patients who had undergone initial surgical excision.…”

Section: Pseudoangiomatous Stromal Hyperplasia Tumor M Ferreira Et Almentioning

confidence: 70%

“…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: Discussionmentioning

confidence: 99%

“…[7][8][9][10] Because of the rarity of pseudoangiomatous stromal hyperplasia tumors and uncertainty about their clinical behavior, surgical excision has been the recommended treatment. 1,3,6 Recently, most cases are initially diagnosed by image-guided core needle biopsy, which allows the option of close clinical and radiologic surveillance instead of surgical excision. No studies have yet evaluated the long-term clinical outcome of patients with pseudoangiomatous stromal hyperplasia tumors who undergo surveillance instead of surgical excision.…”

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confidence: 99%

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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: Pseudoangiomatous Stromal Hyperplasia Tumor M Ferreira Et Almentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Ferreira¹,

2008

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“…It was also suggested that there may be a relationship between these 'pre-lymphatic channels' and the spaces seen in pseudoangiomatous stromal hyperplasia, which, similar to retraction clefts, are apparent on frozen sections and are considered to represent real spaces as opposed to an artifactual phenomenon by several investigators. 36, 37 Damiani et al 36 have described malignant neoplasms in the breast that appeared to spread through the spaces of pseudoangiomatous stromal hyperplasia supporting the view that these spaces are real, likely represent the 'pre-lymphatic channels' of Hartveit and suggested that they may represent a previously unrecognized pathway of tumor spread. Given the observed association of the extensive presence of retraction clefts with lymphangiogenesis, as measured by lymphatic vessel density and VEGF-C expression, and lymphatic tumor spread, we propose that retraction clefts are real spaces, likely related to the 'pre-lymphatic channels' of Hartveit, 35 which may represent an early stage of lymphatic invasion.…”

Section: Discussionmentioning

confidence: 98%

The extent of retraction clefts correlates with lymphatic vessel density and VEGF-C expression and predicts nodal metastasis and poor prognosis in early-stage breast carcinoma

et al. 2012

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Although the earliest feature of disseminated disease in breast cancer is regional lymph node involvement, little is known about the mechanisms whereby cancer cells interact with lymphatic endothelial cells and enter the lymphatic system. We have previously reported that the extensive presence of retraction clefts in breast carcinomas highly significantly correlates with lymphatic tumor spread and predicts poor outcome, suggesting that retraction clefts are not just fixation artifacts, but real potential spaces that are exaggerated by tissue processing and may reflect an early stage of lymphatic invasion. In this study, we examined the correlation between the extent of retraction clefts and lymphangiogenesis, as assessed by lymphatic vessel density and vascular endothelial growth factor-C (VEGF-C) expression in a series of 256 early-stage breast carcinomas. The presence and extent of retraction clefts around tumor cell nests was determined by review of all hematoxylinand eosin-stained tumor sections. Lymphatic vessels were detected by podoplanin immunohistochemistry and lymphatic vessel density was measured using the hot-spot method. The expression of VEGF-C in the tumor cells was determined by immunohistochemistry and analyzed semiquantitatively on a four-tiered scale. High levels of retraction clefts, peritumor lymphatic vessel density and VEGF-C expression at the invasive edge in breast carcinomas significantly correlated with tumor size, histological grade, lymphatic invasion and nodal metastasis. Breast carcinomas showing extensive retraction clefts (420% of tumor volume) were found to have significantly higher lymphatic vessel density and VEGF-C expression levels compared to tumors without this feature. High retraction clefts, peritumor lymphatic vessel density and VEGF-C expression predicted poor outcome in breast carcinomas. Our results support the hypothesis that retraction clefts are real potential spaces that may represent 'pre-lymphatic spaces' facilitating initial lymphatic invasion and that growth factors secreted by the tumor cells may stimulate tumor-associated lymphangiogenesis by promoting the endothelialization of these 'pre-lymphatic channels'.

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“…La hiperplasia estromal pseudoangiomatosa de la mama (por sus siglas en inglés PASH), fue descrita por primera vez en 1986 por Vuitch et al (12). Es una proliferación benigna poco frecuente de células estromales mesenquimales, con formaciones de ranura irregulares parecidas a estructuras angiomatosas (13,14).…”

Section: Introductionunclassified

Hiperplasia virginal mamaria asociado a hiperplasia pseudoangiomatosa del estroma mamario difuso

Bonilla-Sepúlveda

2016

CES Med

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ResumenSe presenta el caso de una mujer de 20 años de edad con crecimiento mamario severo bilateral tipo gigantomastia, de tres meses de evolución, quien fue valorada inicialmente en hospital de primer nivel de complejidad, donde se le hizo diagnóstico de mastitis aguda, la cual no tuvo respuesta a los antibióticos y cuya biopsia de mama fue sospechosa para angiosarcoma mamario, por lo cual remiten a un tercer nivel. Allí fue valorada por el grupo de mastología que reorienta el diagnóstico luego de exámenes complementarios, documentándose así una poco frecuente asociación entre hipertrofia virginal mamaria e hiperplasia pseudoangiomatosa del estroma mamario difusa. Se revisa la presentación clínica de ambas entidades y su diagnóstico diferencial.Palabras clave: Hiperplasia, Hipertrofia, Mesodermo, Mama. AbstractPresents a woman of 20 years old with severe bilateral mammary growth rate type gigantomastia with three months of duration. Initially valued and diagnosed at first level as an acute mastitis, which didn't respond to antibiotics. A mammary biopsy was suspicious for breast angiosarcoma, and refered, valued by mastology that reorients the diagnosis after further examination and biopsy, and documenting a rare association between virginal breast hypertrophy and difuse pseudoangiomatous hyperplasia of the mammary stroma, which together with a good diagnosis could receive appropriate treatment. The clinical presentation of the diseases and their differential diagnosis is reviewed.

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Pseudoangiomatous hyperplasia of mammary stroma

Cited by 290 publications

References 10 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

The extent of retraction clefts correlates with lymphatic vessel density and VEGF-C expression and predicts nodal metastasis and poor prognosis in early-stage breast carcinoma

Hiperplasia virginal mamaria asociado a hiperplasia pseudoangiomatosa del estroma mamario difuso

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