Pseudoangiomatous Stromal Hyperplasia (PASH), A Rare Benign Breast Disease: A Case Report

Abstract

Background: Aberration in normal development and involution (ANDI) is a broad term including the disorders and diseases of breast. Pseudoangiomatous stromal hyperplasia (PASH) is a rare disease of the breast mimicking the neoplasm of the breast and has a wide range of symptoms, which can often complicate clinical assessment and lead to inappropriate treatment of a condition that is basically benign. In the present case report we document this rare benign breast condition (PASH) presenting with mixing features of fibroadenoma and neoplasm. Usually, it affects women of reproductive age. It may manifest as a firm, painless mass also known as tumorous or nodular PASH(Nassar et.al., 2008). Case: A 26 yr old female presented with a lump in left breast for 8 months associated with moderate pain in left breast for 1 month. Breast ultrasound revealed a hypoechoic lesion with multiple coarse foci of calcification and few areas of vascularity- BIRADS IV. Excision and biopsy was done followed by lumpectomy. Histopathology showed terminal duct lobular units with intervening stroma showing dense keloid-like hyalinisation enclosing inter-anastomosing spaces with few endothelial-like lining cells. Focal areas of calcification noted with focal peripheral ductal hyperplasia. Conclusion: Considering the clinical findings and histopathological report with immunochemistry, PASH can be confidently diagnosed and appropriately treated.