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Jang YC, Hung WC, Su TC, Wu WP. Primary pulmonary epithelioid hemangioendothelioma. BMJ Case Rep 2023; 16:e254915. [PMID: 37709495 PMCID: PMC10503352 DOI: 10.1136/bcr-2023-254915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
Pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumour of vascular origin with low to intermediate malignancy. Typical radiological finding on CT is multiple small nodules in bilateral lungs, and some will have punctate calcifications and pleural thickening. The diagnosis of PEH is confirmed by histopathological findings and positive immunohistochemistry staining. We report a case of a woman in her 50s with a medical history of lung adenocarcinoma. Later, regular chest CT during a routine cancer follow-up revealed multiple small pulmonary nodules and increased sizes of these nodules on serial images, initially misdiagnosed as multiple lung metastases. The histopathological diagnosis was made on a pulmonary wedge resection. Finally, PEH was diagnosed on the basis of positive immunohistochemical staining for CD31, ERF and TFE3. In the current study, the clinicopathological features and review of the literature were investigated. Our case highlights the importance of a histological diagnosis to avoid misdiagnosis.
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Affiliation(s)
- Yong Ching Jang
- Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan
| | - Wei-Chien Hung
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Tzu-Cheng Su
- Department of Pathology, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Pei Wu
- Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
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2
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Chen PK, Lin QT, Feng YZ, Weng ZP, Cai XR. Epithelioid hemangioendothelioma of spine: A case report with review of literatures. Radiol Case Rep 2020; 15:2687-2692. [PMID: 33117468 PMCID: PMC7581828 DOI: 10.1016/j.radcr.2020.10.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/10/2020] [Accepted: 10/10/2020] [Indexed: 01/07/2023] Open
Abstract
Primary epithelioid hemangioendothelioma of the spine is the extremely rare malignant vascular neoplasm with an unpredictable outcome. A case of epithelioid hemangioendothelioma with multiple lytic lesions of thoracolumbar spine and other bones in a 29-year-old male patient is reported. A review of the published data regarding this rare neoplasm is also presented. The features of epithelioid hemangioendothelioma include the occurrence in the young male patient, multiple osteolytic lesions with thin sclerotic rim and hypermetabolic activities. However, its imaging features are not specific. Positron emission tomography/computed tomography is essential for identification of the lesions and subsequent follow-up for treatment.
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Affiliation(s)
- Ping-Kang Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, Guangdong, China
| | - Qi-Ting Lin
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, Guangdong, China
| | - You-Zhen Feng
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, Guangdong, China
| | - Ze-Ping Weng
- Department of Pathology, First Affiliated Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Xiang-Ran Cai
- Medical Imaging Center, First Affiliated Hospital of Jinan University, No.613 West Huangpu Avenue, Tianhe District, Guangzhou 510630, Guangdong, China
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3
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Sasaki A, Egashira H, Sugimoto H, Seki K, Tsukiyama T, Ichita C, Tokoro S, Takizawa S, Kitagawa I, Teshima S, Kako M. CT-guided Biopsy for the Diagnosis of Pulmonary Epithelioid Hemangioendothelioma Mimicking Metastatic Lung Cancer. Intern Med 2018; 57:3631-3635. [PMID: 30101918 PMCID: PMC6355408 DOI: 10.2169/internalmedicine.1063-18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
A 69-year-old male patient presented with multiple lung nodules revealed by chest-computed tomography (CT) during a preoperative examination for an appendiceal tumor. The nodule diameters ranged from 2-10 mm without either pleural thickening or effusions. A fluorine-18-labeled fluorodeoxyglucose (18F-FDG)-positron emission tomography (PET)/CT scan showed a high FDG uptake in the appendiceal tumor, but almost normal standardized uptake values in the bilateral lung nodules. A CT-guided biopsy led to a diagnosis of pulmonary epithelioid hemangioendothelioma, a rare vascular tumor with a radiological presentation similar to that of a metastatic lung tumor. The present case is the first to describe successful treatment using a CT-guided biopsy instead of more conventional methods.
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Affiliation(s)
- Akiko Sasaki
- Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Japan
| | - Hideto Egashira
- Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Japan
| | | | - Kenichi Seki
- General Internal Medicine, Shonan Kamakura General Hospital, Japan
| | - Toshitaka Tsukiyama
- Intervention Radiology (IVR) and Radiology, Shonan Kamakura General Hospital, Japan
| | - Chikamasa Ichita
- Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Japan
| | - Shinnosuke Tokoro
- Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Japan
| | - Satoshi Takizawa
- Intervention Radiology (IVR) and Radiology, Shonan Kamakura General Hospital, Japan
| | - Izumi Kitagawa
- General Internal Medicine, Shonan Kamakura General Hospital, Japan
| | | | - Makoto Kako
- Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Japan
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Abdalla A, Seedahmed E, Bachuwa G, Congdon D. Lung lobar collapse as the first manifestation of pulmonary epithelioid haemangioendothelioma diagnosed with fibreoptic bronchoscopy. BMJ Case Rep 2016; 2016:bcr-2016-216411. [PMID: 27797814 DOI: 10.1136/bcr-2016-216411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Pulmonary epithelioid haemangioendothelioma (PEH) is a rare tumour of endothelial origin that usually occurs in the lung and liver. It usually presents as bilateral multiple nodular lesions. We report a middle-aged woman with a unique presentation of PEH with lung lobar collapse. The diagnosis was made with fibreoptic bronchoscopy rather than video-assisted thoracoscopy. Clinicians and pathologists should be aware of rare conditions that can present as lung lobar collapse.
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Calabrese C, Gilli M, De Rosa N, Di Crescenzo V, Zeppa P, Vitale C, Vatrella A. Role of FDG-PET scan in staging of pulmonary epithelioid hemangioendothelioma. Open Med (Wars) 2016; 11:158-162. [PMID: 28352786 PMCID: PMC5329812 DOI: 10.1515/med-2016-0025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/07/2016] [Indexed: 12/25/2022] Open
Abstract
In this report we describe a case of pulmonary epithelioid hemangioendothelioma (PEH) in a young woman. The neoplasm manifested with dry cough, chest pain, finger clubbing, and multiple bilateral pulmonary nodules on chest x-ray and computed tomographic (CT) scan. She underwent thoracoscopy, and the histological features of the lung biopsies were initially interpreted as consistent with a not-well-defined interstitial lung disease. Our patient was clinically and radiologically stable over a period of four years, after which the disease progressed to involve not only the lung but also mediastinal lymph nodes, liver and bone. Fiberoptic bronchoscopy showed subtotal occlusion of the right middle and lower lobe bronchi. The histologic examination of bronchial biopsies revealed a poorly differentiated neoplasm immunohistochemically positive for vimentin and vascular markers CD31, CD34 and Factor VIII. A diagnosis of malignant hemangioendothelioma was made. Positron emission tomography (PET) is more sensitive than CT scan and bone scintigraphy in detecting PEH metastases. Furthermore, 18-fluorodeoxyglucose (FDG) uptake seems to be related to the grade of malignancy of PEH lesions. Therefore, we suggest that FDG-PET should be included in the staging system and follow-up of PEH.
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Affiliation(s)
- Cecilia Calabrese
- Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Naples, Italy
| | - Marina Gilli
- Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Naples, Italy
| | - Nicolina De Rosa
- AORN Ospedale dei Colli, Division of Pulmonary Oncology, Naples, Italy
| | - Vincenzo Di Crescenzo
- AORN Ospedale dei Colli, Division of Pathology, Naples, Italy
- Department of Medicine and Surgery, Section of Respiratory Disease, University of Salerno, Salerno, Italy
| | - Pio Zeppa
- AORN Ospedale dei Colli, Division of Pathology, Naples, Italy
- Department of Medicine and Surgery, Section of Respiratory Disease, University of Salerno, Salerno, Italy
| | - Carolina Vitale
- AORN Ospedale dei Colli, Division of Pathology, Naples, Italy
- Department of Medicine and Surgery, Section of Respiratory Disease, University of Salerno, Salerno, Italy
| | - Alessandro Vatrella
- University of Salerno, Department of Medicine and Surgery, Baronissi Campus, Via S. Allende, Baronissi (SA), Italy
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FDG PET/CT Findings of Multifocal Epithelioid Hemangioendotheliomas of the Bones. Clin Nucl Med 2016; 40:821-2. [PMID: 26018717 DOI: 10.1097/rlu.0000000000000810] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Epithelioid hemangioendothelioma of the bones is very rare. We report a 78-year-old patient suffering from epithelioid hemangioendothelioma of multiple pelvic bones and the right femur. FDG PET/CT scan showed intense activity in mainly lytic lesions of these bones.
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Sardaro A, Bardoscia L, Petruzzelli MF, Portaluri M. Epithelioid hemangioendothelioma: an overview and update on a rare vascular tumor. Oncol Rev 2014; 8:259. [PMID: 25992243 PMCID: PMC4419652 DOI: 10.4081/oncol.2014.259] [Citation(s) in RCA: 124] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 09/18/2014] [Accepted: 09/30/2014] [Indexed: 12/12/2022] Open
Abstract
Epithelioid hemangioendothelioma is a rare vascular tumor, described for the first time in 1975 by Dail and Liebow as an aggressive bronchoalveolar cell carcinoma. The etiology is still a dilemma. Studies about suggestive hypothesis are ongoing. Most of the times it affects lung, liver and bones, although this kind of tumor may involve the head and neck area, breast, lymph nodes, mediastinum, brain and meninges, the spine, skin, abdomen and many other sites. Because of its heterogeneous presentation, as it represents less than 1% of all the vascular tumors, it is often misdiagnosed and not suitably treated, leading to a poor prognosis in some cases. Over 50-76% of the patients are asymptomatic. A small number of them complains respiratory symptoms. Bone metastases might cause pathological fractures or spine compression, if they arise in vertebrae. Imaging is necessary to determine morphological data, the involvement of surrounding tissues, and potentially the cleavage plan. It is important to recognize the expression of vascular markers (Fli-1 and CD31 are endothelial-specific markers), and the microscopic evidence of vascular differentiation to make a correct diagnosis, as many pulmonary diseases show multiple nodular lesions. Because of its rarity, there is no standard for treatment. We focused on radiotherapy as a good therapeutic option: despite the poor prognosis, evidence is in favor of radiotherapy which offers local pain control with good tolerance and better quality of life at least at a one-year follow-up in most of cases. Further studies are needed to establish the standard radiation dose to be used for locoregional control of such a complex and extremely rare disease.
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Affiliation(s)
- Angela Sardaro
- Department of Interdisciplinary Medicine, Section of Diagnostic Imaging and Radiotherapy, University Aldo Moro, Bari
| | - Lilia Bardoscia
- Department of Interdisciplinary Medicine, Section of Diagnostic Imaging and Radiotherapy, University Aldo Moro, Bari
| | - Maria Fonte Petruzzelli
- Department of Interdisciplinary Medicine, Section of Diagnostic Imaging and Radiotherapy, University Aldo Moro, Bari
| | - Maurizio Portaluri
- Department of Radiotherapy, A. Perrino Hospital, Brindisi
- Clinical Physiology Institute, National Research Council (IFC-CNR), Pisa-Lecce, Italy
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Nizami I, Mohammed S, Abouzied MED. Pulmonary epitheloid hemangioendothelioma PET CT findings and review of literature. Ann Saudi Med 2014; 34:447-9. [PMID: 25827705 PMCID: PMC6074559 DOI: 10.5144/0256-4947.2014.447] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We describe a case of pulmonary epitheloid hemangioendothelioma (PEH) in a 13 years old girl, the aggressive nature of the tumor in this particular case and the PET CT findings. PEH are rare tumors of vascular origin, first described by Dial and Liebow in 1975. This is an uncommon pulmonary neoplasm, 4 times more common in young women. This tumor can affect multiple organs (lung, liver, bones and soft tissue, skin, heart, central nervous system). However lung and liver represent 2 main locations. Clinical manifestations are variable; typically patients are asymptomatic, and PEH is detected on routine chest radiographs as bilateral small (1 cm or less) nodules in the lungs Diagnosis usually requires a surgical lung biopsy. The prognosis is very unpredictable, with life expectancy ranging from 1 to 15 years. The tumor is usually considered as low to intermediate grade sarcoma. There is no single effective treatment however spontaneous remissions and aggressive behavior has been described.
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Affiliation(s)
- Imran Nizami
- Dr. Imran Yaqoob Nizami, Organ Transplant Center, MBC 96, King Faisal Specialist Hospital and Research Centre, PO Box 3354 Riyadh 11211, Saudi Arabia, T: 966-11-4647272 loc 76164, F: 966-11-4647272 loc 76167,
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9
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Iimuro Y, Nakai N, Asano Y, Uyama N, Suzumura K, Nakai M, Nakasho K, Kashiwagi T, Fujimoto J. Primary epithelioid hemangioendothelioma of the retroperitoneum: report of a case. Surg Today 2012; 42:1026-31. [PMID: 22484984 DOI: 10.1007/s00595-012-0173-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 08/15/2011] [Indexed: 10/28/2022]
Abstract
We herein report the case of a 48-year-old Japanese female with retroperitoneal epithelioid hemangioendothelioma (EHE), a rare malignant vascular tumor of intermediate grade. She was referred to our hospital because a retroperitoneal tumor was found during a medical checkup, in which strong accumulation of (18)F-fluorodeoxyglucose (FDG) was observed by (18)F-FDG-positron emission tomography (PET). A histological examination of the resected tumor revealed that it consisted of large epithelioid cells with vesicular nuclei, and clear cells with vacuolated cytoplasm and intracytoplasmic lumina. These cells expressed CD31 and vimentin, and the final pathological diagnosis was EHE. Postoperative surveillance with FDG-PET revealed distant metastasis in Virchow's lymph node 7 months after the operation. After dissection of the metastatic lymph node, the patient has been free from recurrence for 13 months. Close follow-up with FDG-PET seemed to be useful for surveillance of the recurrence of this tumor with unpredictable behavior, making an early treatment for the recurrent lesions possible.
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Affiliation(s)
- Yuji Iimuro
- Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishimoniya 663-8501, Japan.
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Moskowitz HS, Jaffe R, Hirsch BE. Epithelioid hemangioendothelioma of the middle ear in a child. Am J Otolaryngol 2011; 32:259-62. [PMID: 20444524 DOI: 10.1016/j.amjoto.2010.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2010] [Accepted: 03/25/2010] [Indexed: 10/19/2022]
Abstract
The differential diagnosis of middle ear masses encompasses a wide variety of pathologic conditions. In this report, we describe the case of a 6-year-old girl who presented with facial nerve weakness and was found to have a middle ear mass. The mass was excised, and final pathology revealed hemangioendothelioma. This report describes the youngest patient with this diagnosis presenting as a middle ear mass in the Western literature. This article provides this patient's presentation, imaging and histopathologic findings, and clinical course and reviews the current literature on this unique pathologic diagnosis.
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11
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Abiko T, Koizumi S, Takanami I, Tanaka F. 18F-FDG-PET/CT findings in primary pulmonary mixed squamous cell and glandular papilloma. Ann Nucl Med 2010; 25:227-9. [PMID: 21188658 DOI: 10.1007/s12149-010-0454-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Accepted: 11/05/2010] [Indexed: 11/25/2022]
Abstract
A 55-year-old female had an abnormal shadow on chest radiograph. Computed tomography (CT) revealed a 26-mm tumor mass in the left upper lobe. No malignant findings were obtained by bronchoscopic cytology or histopathological diagnostics, but on positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) examination the maximum SUV was 9.01 in accordance with the tumor mass shadow on CT. Video-assisted thoracoscopic surgery was performed as clinically suspected of lung cancer, and the diagnosis was pulmonary mixed squamous cell and glandular papilloma (PMSGP). Primary PMSGP is extremely rare, and this is the first to describe the PET findings of this disease.
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Affiliation(s)
- Tomohiro Abiko
- Department of surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
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12
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F-18 FDG PET/CT monitoring of radiation therapeutic effect in hepatic epithelioid hemangioendothelioma. Clin Nucl Med 2009; 34:199-202. [PMID: 19352294 DOI: 10.1097/rlu.0b013e3181966f45] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We report the F-18 FDG PET/CT findings in a 59-year-old man with a rare hepatic tumor of malignant epithelioid hemangioendothelioma, who was treated with radiotherapy (RT). This patient had multifocal discrete hepatic tumors, and PET/CT images showed intense FDG uptake in these nodules, regardless of poor enhancement on contrast-enhanced computed tomography. Seven months after RT to the 2 relatively large nodules, the intense FDG uptake disappeared in these nodules, while the remaining untreated nodule showed persistently intense uptake. RT is one of the options for treatment of hepatic epithelioid hemangioendothelioma. F-18 FDG PET/computed tomography appears to be useful for monitoring the effect of RT in this neoplasm.
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Paik JY, Ko BH, Jung KH, Lee KH. Fibronectin Stimulates Endothelial Cell 18F-FDG Uptake Through Focal Adhesion Kinase–Mediated Phosphatidylinositol 3-Kinase/Akt Signaling. J Nucl Med 2009; 50:618-24. [DOI: 10.2967/jnumed.108.059386] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Aissa I, Khaldi H, Yacoub Z, Ayadi-Kadour A, El Mezni F, Capron F, Ghedira H. [Epithelioid hemangioendothelioma mimicking hypersensitivity pneumonitis]. REVUE DE PNEUMOLOGIE CLINIQUE 2008; 64:173-177. [PMID: 19019284 DOI: 10.1016/j.pneumo.2008.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Epithelioid haemangioendothelioma is a rare vascular tumour of slow growth and unfavourable outcome. The diagnosis of the pulmonary localisation is difficult and can mimic by clinical and radiological features other diagnosis as hypersensitivity pneumonitis. We report the case of a 28-year-old man, farmer handling with palm tree pollens, admitted to the hospital for dry cough. Clinical and thoracic computed tomography findings revealed diffuse infiltrating pneumopathy; bronchoalveolar lavage results and professional exposure were suggestive for hypersensivity pneumonitis. Surgical lung biopsy with immunochemistry study concluded to pulmonary epithelioid haemangioendothelioma. Extra pulmonary localisation research was negative. No treatment was indicated. At three years, the patient is steel asymptomatic. Epithelioid haemangioendothelioma is a tumour of intermediate malignancy, of which pulmonary localisation has a nonspecific clinical presentation mimicking diffuse infiltrating pneumonitis. Diagnosis is essentially made by surgical lung biopsy with pathological and immunohistochemical study.
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Affiliation(s)
- I Aissa
- Service de pneumologie-I, hôpital de pneumo-phtisiologie Abderrahman-Mami, 2080 L'Ariana, Tunis, Tunisie.
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Watanabe S, Yano F, Kita T, Soga S, Shinmoto H, Kosuda S, Ozeki Y, Aida S, Sakata I. 18F-FDG-PET/CT as an indicator for resection of pulmonary epithelioid hemangioendothelioma. Ann Nucl Med 2008; 22:521-4. [PMID: 18670859 DOI: 10.1007/s12149-007-0159-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2007] [Accepted: 09/11/2007] [Indexed: 11/25/2022]
Abstract
A 60-year-old man with a 7-year history of multiple pulmonary nodules presented to our hospital because the nodules were seen to have increased in size on review of films on a regular medical checkup 1 week earlier. Computed tomography (CT) revealed multiple pulmonary nodules with calcification in the lungs. The largest nodule measuring 2.5 cm in the maximum dimension was lobulated and ill-defined. The patient underwent 18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG-PET/CT) to evaluate the multiple nodules and to search for a primary lesion. 18F-FDG-PET/CT revealed increased uptake in only two nodules with a standardized uptake value of 4.61 and 2.10, respectively. The two foci with increased 18F-FDG uptake were resected and pathologically proven to be pulmonary epithelioid hemangioendothelioma (PEH). PEH can transform into malignancy with metastasis. An 18F-FDG-PET/CT finding may be an indicator to decide on PEH resection.
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Affiliation(s)
- Sadahiro Watanabe
- Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Japan
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Koch M, Nielsen GP, Yoon SS. Malignant tumors of blood vessels: angiosarcomas, hemangioendotheliomas, and hemangioperictyomas. J Surg Oncol 2008; 97:321-9. [PMID: 18286475 DOI: 10.1002/jso.20973] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Sarcomas that arise from or resemble the components of blood vessels are uncommon and include angiosarcomas, hemangioendotheliomas, and hemangiopericytomas. This article reviews the management of these three types of sarcomas. Diagnosis can sometimes be difficult, with the diagnosis of hemangiopericytoma versus solitary fibrous tumor currently in debate. Each of these sarcomas subtypes has certain unique clinical traits. The mainstay of treatment is surgical resection, sometimes combined with radiation therapy. Adjuvant chemotherapy is unproven but can be considered. For patients with advanced disease, various chemotherapeutic regimens may result in meaningful responses in a minority of patients.
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Affiliation(s)
- Moritz Koch
- Department of Surgery, University of Heidelberg, Heidelberg, Germany
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