Pseudoangiomatous stromal hyperplasia (PASH) is a benign tumor that usually occurs in the breast and is similar to fibroadenomas. It is diagnosed using ultrasound, mammography, and MRI, and surgery is recommended for large tumors. Further study is needed due to the limited number of cases.
Stromal hyperplasia, better known as pseudoangiomatous stromal hyperplasia (PASH), is a type of benign tumor that arises from supporting cell tissue and usually occurs in the breast. It was first discovered in 1986 when a team of three medical researchers noticed nine cases of breast injury. There have been very few cases of stromal hyperplasia since then, leading to a lack of meaningful studies of the condition.
Typically, PASH develops from the myofibroblast cells of the body. These are cells that function as a hybrid between muscle cells known as fibroblasts and smooth or non-smooth muscle cells. The structure of stromal hyperplasia can be described as rubbery and firm, made up of fibrous and glandular tissue. It also provides no pain and is unilateral, meaning that it occurs in one of the paired parts of the body. There are some cases, however, where the protrusion has appeared in both structures.
That description makes PASH similar to fibroadenomas, which are benign tumors that commonly appear in the breast. The differentiating factor of stromal hyperplasia is its lack of malignancy. It was the ability to tell whether or not the lesions were angiosarcoma that allowed the researchers to distinguish stromal hyperplasia as a distinctive condition. Angiosarcoma refers to a set of tumors characterized by uncontrolled growth and danger to health, consequently denoting cancer. Although it can grow, stromal hyperplasia is not cancerous.
The similarities of PASH and fibroadenomas sometimes make it difficult to diagnose either condition, especially the former. The condition is usually diagnosed during a second or third visit to the medical center. Ultrasound, mammography, and magnetic resonance imaging (MRI) are the techniques used to diagnose stromal hyperplasia.
Doctors recommend surgery for patients with large PASH tumors. In some cases, the surgeon would proceed with an operation even if the diagnosis does not confirm that diagnosis, as a precautionary measure against cancer. In the most extreme cases, mastectomies have been performed, which involve the complete removal of one breast. A follow-up examination is recommended, as there have been situations where the lesions have recurred.
Since its differentiation in the mid-1980s, stromal hyperplasia has required further study. Even though it is a benign and non-cancerous condition, the medical community has yet to determine its significance. Since very few cases of pseudoangiomatous stromal hyperplasia have been documented over the years, the possibility of thorough investigation of the event has been limited.
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