両測腋窩副乳, 乳腺 Pseudoangiomatous stromal hyperplasia (PASH) の1例 [in Japanese] A CASE OF BILATERAL AXILLARY ACCESSORY BREASTS AND MAMMARY PSEUDOANGIOMATOUS STROMAL HYPERPLASIA (PASH) [in Japanese]
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両側腋窩副乳と乳腺Pseudoangiomatous stromal hyperplasia（PASH）の1例を経験したので報告する．症例は45歳，女性．両側乳房と左腋窩の腫大，発赤を主訴で受診した．両側乳房は腫大し左腋窩腫瘤を認めた．胸部CT検査にて両側乳腺はびまん性に腫大し，左腋窩に約10cmの軟部腫瘤を認めた．診断目的で左腋窩腫瘤摘出術を行った．腋窩副乳PASHの診断であった．その後両側乳腺はさらに腫大しかつ左右腋窩腫瘤も出現したため両側単純乳房切除術左右腋窩腫瘤摘出術を行った．HE染色では乳腺間質内にスリット状，血管様の間隙を認め，その間隙内面は，一層の紡錘形細胞に覆われていた．免疫組織学的染色では，間隙内の紡錘形細胞はCD34に陽性，第8因子関連抗原に陰性であった．以上より両側腋窩副乳，乳腺PASHと診断した．今回，自験例に若干の文献的考察を加えて報告する．
We report our experience with a case of bilateral axillary accessory breasts and mammary pseudoangiomatous stromal hyperplasia (PASH). The present patient was a 45-year-old woman who presented with chief complaints of swelling and redness of both breasts as well as the left axilla. In addition to swelling of both breasts, a tumor was observed in the left axilla. Chest CT showed diffuse swelling of both mammary glands in addition to an approximately 10 cm-soft tissue tumor in the left axilla. The left axillary tumor was resected for diagnostic purposes. The patient was subsequently diagnosed with axillary accessory breasts and PASH, and underwent bilateral tolal mastectomy in addition to resection of the left and right axillary tumors due to further swelling of both mammary glands as well as development of tumors in both axillary regions. HE staining showed slit-shaped, vessel-like spaces in the mammary stroma. The inner surface of these spaces was covered by a layer of spindle-shaped cells, which tested positive for CD34 and negative for factor VII-related antigen on immunohistochemical staining. Based on these findings, the patient was diagnosed with bilateral axillary accessory breasts and mammary PASH. We report the present case with reference to literature.
- The journal of the Japanese Practical Surgeon Society
The journal of the Japanese Practical Surgeon Society 69(7), 1595-1600, 2008-07-25
Japan Surgical Association