Pseudoangiomatous Stromal Hyperplasia of the Breast : A Case Report
| Autor: | YOSHIKAWA, Yumiko, ABE, Hajime, OHARA, Ako, YARIYAMA, Kento, YONEDA, Genichiro |
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| Jazyk: | japonština |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | 滋賀医科大学雑誌. 35(1):20-23 |
| Popis: | 乳腺偽血管腫様過形成（pseudoangiomatous stromal hyperplasia、PASH）は、血管様の間隙を伴う間質の増殖を主体とする良性疾患である。今回われわれは46歳女性に発症したPASHの1例を経験したので報告する。症例は4カ月前より徐々に増大する左乳房腫瘤を自覚し、精査加療目的に当科紹介となった。局所所見では左乳房C領域に約9cmの弾性軟の腫瘤を触知した。マンモグラフィおよび超音波所見では境界明瞭な充実性腫瘍を認めた。乳房MRIで腫瘍は脂肪抑制 T2強調像にて低信号を呈し、内部にスリット状の高信号域が認められた。針生検では細胞成分の乏しい膠原線維の増生巣を認め、増生巣内には細血管様の間隙構造が目立った。診断と治療をかねて腫瘍摘出術および広背筋皮弁による一期的乳房再建術を施行した。病理組織学的には細胞成分の乏しい膠原線維の増生からなり、線維組織間に細血管様の裂隙形成が広範囲に生じていた。免疫染色では筋線維芽細胞マーカーが陽性であり、PASHと診断された。 Pseudoangiomatous stromal hyperplasia (PASH) is a benign disease characterized by proliferation of the stroma with vascular-like spaces. We report a case of PASH in a 46-year-old woman. The patient was aware of a left breast mass that had gradually increased in size over the previous 4 months, and was referred to our department for further investigation and treatment. On local examination, an elastic soft mass of about 9 cm in size was palpable in the C region of the left breast. Mammographic and ultrasonographic findings showed a well-defined solid tumor. Breast MRI showed low signal in the fat-suppressed T2-weighted image and a slit-like high signal area inside the tumor. The needle biopsy showed foci of collagenous fibers with poor cellular component, and microvascular-like pore structures were prominent in the foci. For diagnostic and therapeutic purposes, the patient underwent tumor resection and breast reconstruction with a latissimus dorsi muscle flap. Histopathologically, the tumor was composed of collagenous fibers with poor cellularity, and there were extensive microvascular-like fissures between the fibrous tissues. Immunostaining revealed positive myofibroblast markers, and the diagnosis of PASH was made. |
| Databáze: | OpenAIRE |
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