Polger M R, Denison C M, Lester S, Meyer J E
Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115, USA.
AJR Am J Roentgenol. 1996 Feb;166(2):349-52. doi: 10.2214/ajr.166.2.8553945.
Pseudoangiomatous stromal hyperplasia is a benign, localized form of stromal overgrowth with a probable hormonal etiology. Our purpose is to describe the mammographic, sonographic, and clinical features of this entity.
A retrospective review of breast imaging studies and demographic information for seven patients identified as having pseudoangiomatous stromal hyperplasia was performed. The patients were chosen from a 1-year period during which 1661 breast biopsies were performed.
The patients were 36-61 years old. Six were premenopausal, and the one postmenopausal woman was on hormone replacement therapy. Three patients wee evaluated palpable breast lumps, and four were asymptomatic. All seven women had noncalcified masses that measured 1.1-11 cm and that were visible by mammography. The border characteristics were as follows: three masses were well circumscribed, two were partly circumscribed, and two were indistinct, probably because they were obscured by overlying parenchyma. Sonography was performed for five patients; lesions were visible in four. All four of these lesions were solid and circumscribed. Five of the masses had increased in size since earlier studies, and one palpable mass was found by physical examination to have grown over time. Two patients had a local recurrence of pseudoangiomatous stromal hyperplasia. Surgical excision was performed for three patients, large-core biopsy was performed for three patients, and both surgery and large-core biopsy were performed for one patient.
Pseudoangiomatous stromal hyperplasia should be included in the differential diagnosis of a circumscribed or partially circumscribed mass, especially in the premenopausal population. These masses often grow over time and can recur locally. Pathologic diagnosis of the lesion may be difficult unless the pathologist is aware of the presence of a mass lesion and appreciates the stromal changes characteristic of such a lesion.
假血管瘤样间质增生是一种良性局限性间质过度增生形式，可能与激素病因有关。我们的目的是描述该疾病的乳腺钼靶、超声及临床特征。
对7例确诊为假血管瘤样间质增生患者的乳腺影像研究及人口统计学信息进行回顾性分析。这些患者选自1年期间内进行的1661例乳腺活检病例。
患者年龄36 - 61岁。6例为绝经前患者，1例绝经后女性正在接受激素替代治疗。3例患者因可触及乳腺肿块就诊，4例无症状。所有7例女性均有非钙化肿块，大小为1.1 - 11 cm，乳腺钼靶检查可见。边界特征如下：3个肿块边界清晰，2个部分边界清晰，2个边界不清，可能是因为被上方实质组织遮挡。5例患者进行了超声检查，4例可见病变。所有这4个病变均为实性且边界清晰。自早期检查以来，5个肿块大小增大，1个可触及肿块经体格检查发现随时间增长。2例患者出现假血管瘤样间质增生局部复发。3例患者进行了手术切除，3例患者进行了粗针活检，1例患者同时进行了手术和粗针活检。
假血管瘤样间质增生应纳入边界清晰或部分边界清晰肿块的鉴别诊断，尤其是在绝经前人群中。这些肿块常随时间增长且可局部复发。除非病理学家意识到存在肿块病变并认识到此类病变的间质特征性改变，否则病变的病理诊断可能困难。
