Tumoral Pseudoangiomatous Stromal Hyperplasia of the Breast
Tumoral Pseudoangiomatous Stromal Hyperplasia of the Breast
复制标题
乳腺肿瘤性假血管瘤性间质增生
DOI：
10.1177/000313480807401217
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Lauren A. Ross
中科院分区：
文献类型：
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作者：
S. Wieman;J. Landercasper;Jeanne M. Johnson;R. Ellis;S. Wester;P. Lambert;Lauren A. Ross
肿瘤性假性血管瘤性间质增生(PASH)是一种罕见的乳腺良性增生性疾病。PASH的文献报道大多没有详细描述PASH的影像特征。对肿瘤性PASH患者进行了为期10年的回顾性研究，并对Ovid MEDLINE®进行了长达20年的研究，以确定特定的影像和针吸活检结果是否可以在术前确定PASH的特征。我们确定了22例肿瘤PASH患者。22名女性中有17名(77%)有明显的肿块，21名女性中有14名(72%)在乳房X光检查上有密度。超声(US)结果包括83%的患者出现混合或低回声回声，62%的患者边界不清。8例(36%)患者的乳腺影像报告和数据系统(BI-RADS®)分级为4或5。术前核心针吸活检(CNB)诊断PASH的敏感度为83%。对文献的回顾显示，90%的PASH患者具有某些恶性影像特征，95%的患者在乳房X光检查中有肿块。PASH的影像特征具有明显的变异性。对于有症状、病变扩大或BI-RADS®4或5级的患者，可考虑在CNB后切除PASH。经CNB诊断的PASH可使选定的患者避免切除。
Tumoral pseudoangiomatous stromal hyperplasia (PASH) is a rare benign proliferative disease of the breast. The majority of the literature reports of PASH have not contained detailed descriptions of the imaging characteristics of PASH. A 10-year retrospective study of patients with tumoral PASH and a 20-year Ovid MEDLINE® search were performed to determine whether specific imaging and needle biopsy results could characterize PASH preoperatively. We identified 22 patients with tumoral PASH. Seventeen (77%) of 22 women had a palpable lump and 14 (72%) of 21 had a density on mammography. Ultrasound (US) findings included mixed or hypoechoic echogenicity in 83 per cent and ill-defined borders in 62 per cent. Eight (36%) patients had lesions with a Breast Imaging Reporting and Data System (BI-RADS®) classification of 4 or 5. The sensitivity of preoperative core needle biopsy (CNB) to identify PASH was 83 per cent. A review of the literature revealed that 90 per cent of patients with PASH had some malignant imaging characteristics and 95 per cent had a mass on mammography. The imaging characteristics of PASH exhibited marked variability. Excision of PASH after CNB may be considered for patients with symptoms, enlarging lesions, or lesions classified as BI-RADS® 4 or 5. PASH diagnosed by CNB allows selected patients to avoid excision.