Bilateral pseudoangiomatous stromal hyperplasia in a human immunodeficiency viral-infected patient.

ABSTRACT

Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon mesenchymal neoplasm of the breast demonstrating stromal myofi broblastic proliferation and having the appearance of anastomosing slit-like pseudovascular spaces lined by spindle-shaped cells. A case of nodular PASH of the bilateral breasts in a 40-year-old woman with clinically presenting with a progressive enlarged breast lump is reported. Mammographic and ultrasonographic features of the right and left breasts showed a large solid lump with well-circumscribed border measuring 4 cm  1.7 cm  3.4 cm and 13.8 cm  10.9 cm  12.1 cm, respectively. Wide excision of the right breast and quadrantectomy of the left breast were performed. The histopathological examination of the lesion showed anastomosing slit-like pseudovascular spaces. The stromal cells were immunoreactive for muscle actin (HHF35), smooth muscle actin, and progesterone receptor. Clinical and pathological fi ndings with briefl y reviewed relevant literatures are discussed. This is the fi rst clinicopathological and radiological report of bilateral mammary nodular PASH in a human immunodefi ciency viral-infected patient.