Atypical PASH is an extremely rare lesion characterized by cytological alteration of myofibroblast, presenting as myofibroblastic sarcoma arising from PASH.
In this Pass The Cash, we meet a family who has always been on the helping end, not needing help. Furthermore, the benign conditions of the breast that commonly affect women can also impact male patients. Pseudoangiomatous stromal hyperplasia (PASH) in male patients is a rare condition that represents a hormonally-induced proliferation of mesenchymal tissue of the breast.
Pseudoangiomatous Stromal Hyperplasia (PASH) of Breast is a rare, benign tumor of breast, which is observed in young and old women. (B) A diagnostic ultrasound of the right breast shows a hypoechoic irregular mass with angular margins (red outline) and internal vascularity (white arrows), measuring 15 millimeters in the subareolar region.The ultrasound imaging for this patient on his second presentation showed a hypoechoic, irregular mass, with angular margins and without internal vascularity. The 149 patients in the study by Hargaden et al. Pseudoangiomatous Stromal Hyperplasia of the Breast: A Rare Finding in a Male Patient PASH is a benign breast disorder characterized by dense proliferation of the breast stroma forming slit-like pseudovascular spaces lined by spindle cells. As to our knowledge, PASH has not been previously described in the anogenital area, this feature seems to have been either overlooked or is genuinely rare in this location. (C) A diagnostic ultrasound of left breast shows a hypoechoic irregular mass with angular margins (blue circle) with no internal vascularity, measuring 9 millimeters in the subareolar 12 o’clock region.This would commonly halt further workup of a patient’s breast mass, but there was motivation for further pursuit of diagnosis via biopsy, due to this patient’s medical history. The objective of this study was to evaluate the ultrasound features and to present biopsy methods to correctly identify PASH. The following case describes this rare but important instance of a male patient diagnosed with PASH following a previous diagnosis of infiltrative ductal carcinoma in situ of the contralateral breast.Approaching breast masses in male patients is often deemed unchartered territory, without a well-defined clinical algorithm.
Ferreira et al.
(B) The histopathology sample shows a complex network of anastomosing spaces lined by myofibroblasts (light blue arrows) separated by collagenized stroma at a magnification of 200 times.Overall, PASH cases have been scarcely reported since the initial documented case in 1986, by Vuitch et al. When PASH presents as a breast mass, it appears innocent, developing as a smooth and well-circumscribed tumor.
He has an extensive past medical history of chronic obstructive pulmonary disease, coronary artery disease, congestive heart failure, hypertension, hyperlipidemia, type two diabetes mellitus, chronic kidney disease, arthritis, and gout, now burdened with several unexpected conditions of the breast. The more common diagnosis in a male patient includes benign conditions, most frequently gynecomastia.
Published by Elsevier LtdScienceDirect ® is a registered trademark of Elsevier B.V. As expected, this biopsy resembled PASH, in addition to gynecomastia, with increased periductal stromal cellularity, edema, and ductal epithelial hyperplasia with flat or papillary patterns (Figure (A) An ultrasound-guided core biopsy shows increased stromal cellularity and edema at a magnification of 40 times (green arrow). We provide a brief review of the literature on PASH, discussing its clinicopathological features and management.We use cookies to help provide and enhance our service and tailor content and ads. Cureus 11(6): e4923.
There are three sonographic findings characteristic of gynecomastia - nodular, dendritic, and diffuse glandular.
When PASH presents as a breast mass, it appears innocent, developing as a smooth and well-circumscribed tumor. These studies reveal specific markers of pathology that suggest either malignancy or a benign condition.