Zanella M, Falconieri G, Lamovec J, Bittesini L
Division of Anatomic Pathology, City Hospital, Conegliano Veneto TV, Italy.
Pathol Res Pract. 1998;194(8):535-40. doi: 10.1016/S0344-0338(98)80042-3.
We report the clinical and pathologic features seen in 14 cases of pseudoangiomatous hyperplasia of the mammary stroma. The lesion manifested as a discrete palpable lump in twelve women and two men. The excisional biopsy specimens showed firm, circumscribed grey-tan lesions measuring from 3 to 5.5 cm in largest dimension. Histologic study revealed diffuse, anastomosing, enlongated slits with open lumina, covered by spindle cells with bland nuclei and no mitotic activity. Strong reactivity for vimentin and CD34 was noted. Smooth muscle actin was focally noted in most cases. Immunostains for other markers, including CD31 and factor VIII related antigen was negative. Spindle cells from two cases expressed both estrogen and progesterone receptors. In all the cases, there was some degree of glandular hyperplasia accompanying the stromal changes. Fibroadenoma or fibrocystic disease were also common features. Our study confirms that pseudoangiomatous hyperplasia of mammary stroma represents a proliferation of local myofibroblasts, likely related to a hormonal stimulus. The wide range of associated changes of breast parenchyma further indicates that this lesion may represent a local, non specific change rather than a true clinico-pathologic entity.
我们报告了14例乳腺间质假血管瘤样增生的临床和病理特征。该病变在12名女性和2名男性中表现为可触及的离散肿块。切除活检标本显示质地坚实、边界清楚的灰棕色病变，最大直径为3至5.5厘米。组织学研究显示弥漫性、相互吻合的细长裂隙，管腔开放，内衬核温和且无有丝分裂活性的梭形细胞。波形蛋白和CD34呈强阳性反应。大多数病例中平滑肌肌动蛋白呈局灶性阳性。包括CD31和因子VIII相关抗原在内的其他标志物免疫染色均为阴性。2例的梭形细胞同时表达雌激素和孕激素受体。所有病例中，均有一定程度的腺性增生伴随间质改变。纤维腺瘤或纤维囊性疾病也是常见特征。我们的研究证实，乳腺间质假血管瘤样增生代表局部肌成纤维细胞的增殖，可能与激素刺激有关。乳腺实质广泛的相关改变进一步表明，该病变可能代表一种局部的、非特异性改变，而非真正的临床病理实体。
