PMC9872972_01
Diffuse asymmetrical bilateral enlargement of the breasts due to PASH.
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F1
Postoperative specimen.
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F2
A bilateral mastectomy with free NAC grafting was performed (Fig. 2).
The intralobular and interlobular stroma presents multiple, anastomosing, slit-like spaces lined by a single layer of spindle-shaped myofibroblasts simulating endothelial cells. There is no evidence of cytologic atypia. (Hematoxylin and eosin, 4x. Insert: hematoxylin and eosin, 20x).
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F3
Histopathological examination of the excised breast tissue revealed a complex network of slit-like spaces within a dense collagenous stroma, expanding the intralobular and interlobular compartments of both breasts (Fig. 3). These optically empty spaces were lined by a population of spindle cells with no atypia and no evidence of mitotic activity (Fig. 3, insert), showing immunohistochemical positivity for cluster differentiation 34 and negativity for cluster differentiation 31 estrogen receptors, and progesterone receptors. These findings were consistent with the diagnosis of diffuse, bilateral PASH (Fig. 3).
Postoperative result after 2 months. Note the free NAC graft necrosis bilaterally and subsequent healing by secondary intention.
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F4
The patient had an uneventful postoperative period, with exception of free NAC graft necrosis bilaterally and subsequent healing by secondary intention (Fig. 4).