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Pseudoangiomatous stromal hyperplasia (PASH)

Case contributed by Dr Mahmoud Alkhouly


Large left breast and some pain. Clinical examination is suspicious for malignancy.

Patient Data

Age: 30 years
Gender: Female

MLO mammogram of the left breast shows well-circumscribed opacity replacing nearly whole breast tissue. No microcalcifications are seen. The mammographic appearance is benign.

Large heterogeneous mass with cystic areas and capsule. There was a good transmission of the ultrasound beam through the lesion. No calcifications or significant Doppler flow.

Case Discussion

PASH is a rare benign proliferative lesion of the mammary stroma. They are usually detectable on mammography and may be seen as a partially circumscribed mass, rarely irregular.

On ultrasound, they present as an oval, well defined hypoechoic mass, rarely with cystic spaces - like our case. Less commonly, they are heterogeneous or hyperechoic.

This particular lesion was biopsied using ultrasound guidance and surgically excised afterwards. Histopathology results confirmed pseudoangiomatous stromal hyperplasia (PASH).

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Case information

rID: 65485
Published: 26th Feb 2019
Last edited: 6th Feb 2020
System: Breast
Inclusion in quiz mode: Included

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