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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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Zeng H, Tang X, Tian X, Liu Y, Tian P. Poor response to sintilimab plus chemotherapy in a pulmonary epithelioid hemangioendothelioma patient: a case report. Immunotherapy 2023; 15:77-83. [PMID: 36695105 DOI: 10.2217/imt-2022-0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor with no established treatment protocol. The authors report the case of a young woman diagnosed with PEH. DNA and RNA analysis by next-generation sequencing was performed on the tumor tissue. A novel germline PALB2 mutation and classical WWTR1-CAMTA1 fusion were identified. She experienced a poor response to sintilimab (a PD-1 inhibitor) plus platinum-based chemotherapy as the first-line treatment. PEH patients harboring a germline PALB2 mutation and WWTR1-CAMTA1 gene fusion may respond poorly to treatment with PD-1 inhibitors plus chemotherapy.
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Affiliation(s)
- Hao Zeng
- Department of Respiratory & Critical Care Medicine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xiaojun Tang
- Lung Cancer Treatment Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xia Tian
- Department of Respiratory & Critical Care Medicine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yujie Liu
- Department of Respiratory & Critical Care Medicine, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Panwen Tian
- Department of Respiratory & Critical Care Medicine, Lung Cancer Treatment Center, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
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Qin C, Hua J, Zhu X, Lu G, Yu H, Bian T. Rapid death due to pulmonary epithelioid haemangioendothelioma in several weeks: A case report. Open Life Sci 2022; 17:811-815. [PMID: 35993095 PMCID: PMC9360581 DOI: 10.1515/biol-2022-0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 11/27/2022] Open
Abstract
A 49-year-old woman was admitted to our hospital because of haemoptysis for 6 days. This patient claimed no medical history except high blood sugar. Chest computed tomography (CT) showed infection and multiple nodules on both sides of the lung. Blood tests showed no obvious abnormalities. Tracheoscopy showed haemorrhagic discharge in the left upper lobe and an old thrombus obstructing the lumen in the anterior basal segment of the right lower lobe. Then, CT-guided percutaneous lung biopsy was performed. The pathological results suggested multiple nodular-like lesions in the submitted tissues, and tumour cells were round or short fusiform, forming a solid nest structure, visible mitosis, and a vascular cavity-like structure containing red blood cells. Immunohistochemistry revealed positive staining for Vimentin, Bcl-2, CD31, and CD34; negative staining for CD68, SMA, CR, and D2-40; and 40% Ki67+ positivity. Based on the earlier data, the patient was diagnosed with pulmonary epithelioid haemangioendothelioma. This patient did not receive any treatment for several reasons. Unfortunately, the patient died 8 weeks after diagnosis. In conclusion, we present a case featuring the rapid death due to PEH.
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Affiliation(s)
- Chu Qin
- Department of Respiratory Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214000, Jiangsu, P.R. China
| | - Jia Hua
- Department of Nephrology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214000, Jiangsu, P.R. China
| | - Xingfeng Zhu
- Department of Thoracic Surgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214000, Jiangsu, P.R. China
| | - Guochu Lu
- Department of Respiratory Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214000, Jiangsu, P.R. China
| | - Haoda Yu
- Department of Respiratory Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214000, Jiangsu, P.R. China
| | - Tao Bian
- Department of Respiratory Medicine, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi 214000, Jiangsu, P.R. China
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Gunn E, Barnett CC, Duong AT, Beierle EA, Kelly DR, Vaid YN, Keene KS, Soike M, Whelan K. Bloom where you are planted: Hemangioma or malignancy? Pediatr Blood Cancer 2022; 69:e29485. [PMID: 34843167 DOI: 10.1002/pbc.29485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/01/2021] [Accepted: 11/08/2021] [Indexed: 12/30/2022]
Abstract
Vascular anomalies comprise a spectrum of disorders characterized by the abnormal development or growth of blood and lymphatic vessels. These growths have unique features and diverse behaviors, mandating a multidisciplinary approach in their evaluation, diagnosis, and management. Here we describe the case of a male toddler presenting with an abdominal mass, originally treated as a metastatic retroperitoneal tumor, but subsequently felt to represent a vascular anomaly.
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Affiliation(s)
- Elizabeth Gunn
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Christopher C Barnett
- Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Anh Teressa Duong
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Elizabeth A Beierle
- Division of Pediatric Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David R Kelly
- Department of Pediatric Pathology and Laboratory Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Yoginder N Vaid
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kimberly S Keene
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Michael Soike
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kimberly Whelan
- Division of Pediatric Hematology Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA
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IKEZAWA M, FUJIMOTO M, NISHIKAWA H, TANIOKA S, KURODA Y, SUZUKI Y, MIZUNO M, SUZUKI H. Intradural Extramedullary Epithelioid Hemangioendothelioma of the Thoracic Spinal Cord: A Case Report. NMC Case Rep J 2021; 8:413-417. [PMID: 35079497 PMCID: PMC8769451 DOI: 10.2176/nmccrj.cr.2020-0332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/07/2020] [Indexed: 11/20/2022] Open
Affiliation(s)
- Munenari IKEZAWA
- Department of Neurosurgery, Suzuka Kaisei Hospital, Suzuka, Mie, Japan
| | - Masashi FUJIMOTO
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | | | - Satoru TANIOKA
- Department of Neurosurgery, Mie Chuo Medical Center, Tsu, Mie, Japan
| | - Yusuke KURODA
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Yume SUZUKI
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - Masaki MIZUNO
- Department of Neurosurgery, Suzuka Kaisei Hospital, Suzuka, Mie, Japan
| | - Hidenori SUZUKI
- Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
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