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PASH
Whitney S. Boyce, MD; Jessica W. T. Leung, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Pseudoangiomatous stromal hyperplasia (PASH)
            • Definitions

              • Pseudoangiomatous hyperplasia of mammary stroma
                • Benign, myofibroblastic, hyperplastic process
                • Contains extensive anastomosing, empty, "pseudoangiomatous," slit-like spaces lined by fibroblasts, mimicking vascular channels but lacking any red blood cells

            IMAGING

            • General Features

              • Mammographic Findings

                • Ultrasonographic Findings

                  • MR Findings

                    • CT Findings

                      • Nuclear Medicine Findings

                        • Image-Guided Biopsy

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Canu GL et al: Pseudoangiomatous stromal hyperplasia (PASH) presenting as axillary lump: case report and review of the literature. G Chir. 39(6):378-382, 2018
                                                2. Torous VF et al: Histopathologic findings in breast surgical specimens from patients undergoing female-to-male gender reassignment surgery. Mod Pathol. ePub, 2018
                                                3. Whorms DS et al: Mesenchymal lesions of the breast: what radiologists need to know. AJR Am J Roentgenol. 211(1):224-233, 2018
                                                4. Kelten Talu C et al: Pseudoangiomatous stromal hyperplasia in core needle biopsies of breast specimens. Int J Surg Pathol. 25(1):26-30, 2017
                                                5. Kurt E et al: How to manage pseudoangiomatous stromal hyperplasia: our clinical experience Turk J Med Sci. 47(5):1410-1415, 2017
                                                6. Raj SD et al: Pseudoangiomatous stromal hyperplasia of the breast: multimodality review with pathologic correlation. Curr Probl Diagn Radiol. 46(2):130-135, 2017
                                                7. Protos A et al: Pseudoangiomatous Stromal Hyperplasia on Core Needle Biopsy Does Not Require Surgical Excision. Am Surg. 82(2):117-21, 2016
                                                8. Bourke AG et al: Pseudoangiomatous stromal hyperplasia causing massive breast enlargement. BMJ Case Rep. 2015, 2015
                                                9. Mizutou A et al: Large pseudoangiomatous stromal hyperplasia complicated with gynecomastia and lobular differentiation in a male breast. Springerplus. 4:282, 2015
                                                10. Roy M et al: Pseudoangiomatous Stromal Hyperplasia: A Rare Cause of Idiopathic Gigantomastia. Plast Reconstr Surg Glob Open. 3(9):e501, 2015
                                                11. Yılmaz E et al: Pseudoangiomatous stromal hyperplasia of the breast: mammosonography and elastography findings with a histopathological correlation. J Breast Health. 11(3):148-151, 2015
                                                12. Bowman E et al: Pseudoangiomatous stromal hyperplasia (PASH) of the breast: a series of 24 patients. Breast J. 18(3):242-7, 2012
                                                13. Celliers L et al: Pseudoangiomatous stromal hyperplasia: a study of the mammographic and sonographic features. Clin Radiol. 65(2):145-9, 2010
                                                14. Degnim AC et al: Pseudoangiomatous stromal hyperplasia and breast cancer risk. Ann Surg Oncol. 17(12):3269-77, 2010
                                                15. Gresik CM et al: Pseudoangiomatous stromal hyperplasia of the breast: a contemporary approach to its clinical and radiologic features and ideal management. Surgery. 148(4):752-7; discussion 757-8, 2010
                                                16. Jones KN et al: Pseudoangiomatous stromal hyperplasia: imaging findings with pathologic and clinical correlation. AJR Am J Roentgenol. 195(4):1036-42, 2010
                                                17. Ferreira M et al: Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases. Mod Pathol. 21(2):201-7, 2008
                                                18. Hargaden GC et al: Analysis of the mammographic and sonographic features of pseudoangiomatous stromal hyperplasia. AJR Am J Roentgenol. 191(2):359-63, 2008
                                                19. Wieman SM et al: Tumoral pseudoangiomatous stromal hyperplasia of the breast. Am Surg. 74(12):1211-4, 2008
                                                20. Leung JW et al: Developing asymmetry identified on mammography: correlation with imaging outcome and pathologic findings. AJR Am J Roentgenol. 188(3):667-75, 2007
                                                21. Zúbor P et al: Rapidly growing nodular pseudoangiomatous stromal hyperplasia of the breast in an 18-year-old girl. APMIS. 114(5):389-92, 2006
                                                22. Goel NB et al: Fibrous lesions of the breast: imaging-pathologic correlation. Radiographics. 25(6):1547-59, 2005
                                                23. Mercado CL et al: Pseudoangiomatous stromal hyperplasia of the breast: sonographic features with histopathologic correlation. Breast J. 10(5):427-32, 2004
                                                24. Moore T et al: Expression of CD34 and bcl-2 in phyllodes tumours, fibroadenomas and spindle cell lesions of the breast. Histopathology. 38(1):62-7, 2001
                                                25. Kirkpatrick UJ et al: Imaging appearances of pseudoangiomatous hyperplasia of mammary stroma. Clin Radiol. 55(7):576-8, 2000
                                                26. Piccoli CW et al: Developing asymmetric breast tissue. Radiology. 211(1):111-7, 1999
                                                27. Simsir A et al: Additional mimics of mucinous mammary carcinoma: fibroepithelial lesions. Am J Clin Pathol. 109(2):169-72, 1998
                                                28. Vicandi B et al: Nodular pseudoangiomatous stromal hyperplasia of the breast. Cytologic features. Acta Cytol. 42(2):335-41, 1998
                                                29. Zanella M et al: Pseudoangiomatous hyperplasia of the mammary stroma: true entity or phenotype? Pathol Res Pract. 194(8):535-40, 1998
                                                30. Badve S et al: Pseudoangiomatous hyperplasia of male breast. Histopathology. 26(5):463-6, 1995
                                                31. Anderson C et al: Immunocytochemical analysis of estrogen and progesterone receptors in benign stromal lesions of the breast. Evidence for hormonal etiology in pseudoangiomatous hyperplasia of mammary stroma. Am J Surg Pathol. 15(2):145-9, 1991
                                                32. Ibrahim RE et al: Pseudoangiomatous hyperplasia of mammary stroma. Some observations regarding its clinicopathologic spectrum. Cancer. 63(6):1154-60, 1989
                                                33. Vuitch MF et al: Pseudoangiomatous hyperplasia of mammary stroma. Hum Pathol. 17(2):185-91, 1986
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Pseudoangiomatous stromal hyperplasia (PASH)
                                                          • Definitions

                                                            • Pseudoangiomatous hyperplasia of mammary stroma
                                                              • Benign, myofibroblastic, hyperplastic process
                                                              • Contains extensive anastomosing, empty, "pseudoangiomatous," slit-like spaces lined by fibroblasts, mimicking vascular channels but lacking any red blood cells

                                                          IMAGING

                                                          • General Features

                                                            • Mammographic Findings

                                                              • Ultrasonographic Findings

                                                                • MR Findings

                                                                  • CT Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Image-Guided Biopsy

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Canu GL et al: Pseudoangiomatous stromal hyperplasia (PASH) presenting as axillary lump: case report and review of the literature. G Chir. 39(6):378-382, 2018
                                                                                              2. Torous VF et al: Histopathologic findings in breast surgical specimens from patients undergoing female-to-male gender reassignment surgery. Mod Pathol. ePub, 2018
                                                                                              3. Whorms DS et al: Mesenchymal lesions of the breast: what radiologists need to know. AJR Am J Roentgenol. 211(1):224-233, 2018
                                                                                              4. Kelten Talu C et al: Pseudoangiomatous stromal hyperplasia in core needle biopsies of breast specimens. Int J Surg Pathol. 25(1):26-30, 2017
                                                                                              5. Kurt E et al: How to manage pseudoangiomatous stromal hyperplasia: our clinical experience Turk J Med Sci. 47(5):1410-1415, 2017
                                                                                              6. Raj SD et al: Pseudoangiomatous stromal hyperplasia of the breast: multimodality review with pathologic correlation. Curr Probl Diagn Radiol. 46(2):130-135, 2017
                                                                                              7. Protos A et al: Pseudoangiomatous Stromal Hyperplasia on Core Needle Biopsy Does Not Require Surgical Excision. Am Surg. 82(2):117-21, 2016
                                                                                              8. Bourke AG et al: Pseudoangiomatous stromal hyperplasia causing massive breast enlargement. BMJ Case Rep. 2015, 2015
                                                                                              9. Mizutou A et al: Large pseudoangiomatous stromal hyperplasia complicated with gynecomastia and lobular differentiation in a male breast. Springerplus. 4:282, 2015
                                                                                              10. Roy M et al: Pseudoangiomatous Stromal Hyperplasia: A Rare Cause of Idiopathic Gigantomastia. Plast Reconstr Surg Glob Open. 3(9):e501, 2015
                                                                                              11. Yılmaz E et al: Pseudoangiomatous stromal hyperplasia of the breast: mammosonography and elastography findings with a histopathological correlation. J Breast Health. 11(3):148-151, 2015
                                                                                              12. Bowman E et al: Pseudoangiomatous stromal hyperplasia (PASH) of the breast: a series of 24 patients. Breast J. 18(3):242-7, 2012
                                                                                              13. Celliers L et al: Pseudoangiomatous stromal hyperplasia: a study of the mammographic and sonographic features. Clin Radiol. 65(2):145-9, 2010
                                                                                              14. Degnim AC et al: Pseudoangiomatous stromal hyperplasia and breast cancer risk. Ann Surg Oncol. 17(12):3269-77, 2010
                                                                                              15. Gresik CM et al: Pseudoangiomatous stromal hyperplasia of the breast: a contemporary approach to its clinical and radiologic features and ideal management. Surgery. 148(4):752-7; discussion 757-8, 2010
                                                                                              16. Jones KN et al: Pseudoangiomatous stromal hyperplasia: imaging findings with pathologic and clinical correlation. AJR Am J Roentgenol. 195(4):1036-42, 2010
                                                                                              17. Ferreira M et al: Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases. Mod Pathol. 21(2):201-7, 2008
                                                                                              18. Hargaden GC et al: Analysis of the mammographic and sonographic features of pseudoangiomatous stromal hyperplasia. AJR Am J Roentgenol. 191(2):359-63, 2008
                                                                                              19. Wieman SM et al: Tumoral pseudoangiomatous stromal hyperplasia of the breast. Am Surg. 74(12):1211-4, 2008
                                                                                              20. Leung JW et al: Developing asymmetry identified on mammography: correlation with imaging outcome and pathologic findings. AJR Am J Roentgenol. 188(3):667-75, 2007
                                                                                              21. Zúbor P et al: Rapidly growing nodular pseudoangiomatous stromal hyperplasia of the breast in an 18-year-old girl. APMIS. 114(5):389-92, 2006
                                                                                              22. Goel NB et al: Fibrous lesions of the breast: imaging-pathologic correlation. Radiographics. 25(6):1547-59, 2005
                                                                                              23. Mercado CL et al: Pseudoangiomatous stromal hyperplasia of the breast: sonographic features with histopathologic correlation. Breast J. 10(5):427-32, 2004
                                                                                              24. Moore T et al: Expression of CD34 and bcl-2 in phyllodes tumours, fibroadenomas and spindle cell lesions of the breast. Histopathology. 38(1):62-7, 2001
                                                                                              25. Kirkpatrick UJ et al: Imaging appearances of pseudoangiomatous hyperplasia of mammary stroma. Clin Radiol. 55(7):576-8, 2000
                                                                                              26. Piccoli CW et al: Developing asymmetric breast tissue. Radiology. 211(1):111-7, 1999
                                                                                              27. Simsir A et al: Additional mimics of mucinous mammary carcinoma: fibroepithelial lesions. Am J Clin Pathol. 109(2):169-72, 1998
                                                                                              28. Vicandi B et al: Nodular pseudoangiomatous stromal hyperplasia of the breast. Cytologic features. Acta Cytol. 42(2):335-41, 1998
                                                                                              29. Zanella M et al: Pseudoangiomatous hyperplasia of the mammary stroma: true entity or phenotype? Pathol Res Pract. 194(8):535-40, 1998
                                                                                              30. Badve S et al: Pseudoangiomatous hyperplasia of male breast. Histopathology. 26(5):463-6, 1995
                                                                                              31. Anderson C et al: Immunocytochemical analysis of estrogen and progesterone receptors in benign stromal lesions of the breast. Evidence for hormonal etiology in pseudoangiomatous hyperplasia of mammary stroma. Am J Surg Pathol. 15(2):145-9, 1991
                                                                                              32. Ibrahim RE et al: Pseudoangiomatous hyperplasia of mammary stroma. Some observations regarding its clinicopathologic spectrum. Cancer. 63(6):1154-60, 1989
                                                                                              33. Vuitch MF et al: Pseudoangiomatous hyperplasia of mammary stroma. Hum Pathol. 17(2):185-91, 1986