Pseudoangiomatous stromal hyperplasia: mammographic, sonographic, and clinical patterns.
OBJECTIVE
To analyze the mammographic, ultrasonographic (US), and clinical patterns of pseudoangiomatous stromal hyperplasia (PASH).


METHODS
Preoperative mammographic and US images, clinical records, and histologic assessments were reviewed in seven cases of PASH as the sole component or dominant stromal component of a clinically or mammographically defined mass lesion. In five, a PASH tumor was diagnosed at image-guided 14-gauge core-needle biopsy; in two, it was diagnosed at surgical excisional biopsy.


RESULTS
Four women were premenopausal, two were postmenopausal, and one 40-year-old patient had iatrogenic primary amenorrhea. Four of seven masses were palpable; three were discovered at mammography. Four masses enlarged over 6 months to 5 years. At mammography, all masses lacked calcifications; six were well defined, and one was spiculated. One was inapparent at US; the remaining six were well defined and hypoechoic.


CONCLUSIONS
The diagnosis of this rare lesion with image-guided breast biopsy or surgical biopsy is consistent with a well-defined uncalcified mass at mammography and a solid hypoechoic mass at US, usually in a premenopausal woman.
Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
M A
MA
Cohen
E A
EA
Morris
P P
PP
Rosen
D D
DD
Dershaw
L
L
Liberman
A F
AF
Abramson
D000328:Adult; D001706:Biopsy; D001940:Breast / Q000473:pathology; D001941:Breast Diseases / Q000000981:diagnostic imaging*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D016217:Ultrasonography, Mammary