Pulmonary Epithelioid Hemangioendothelioma

Carretero, Antonio J.; Elmberger, P. Göran; Sköld, C. Magnus; Collins, Brian T.

doi:10.1159/000325992

Cited by 17 publications

(1 citation statement)

References 8 publications

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“…Most FNA descriptions of EAS and EHE in the literature are case reports or small case series [15,16,17,18,19,20,21,22,23,24,25], with the exception of one larger case series on EHE [26]. A cytomorphological study conducted by Liu and Layfield [27] described common features found in 11 AS, but this study did not exclusively examine EAS.…”

Section: Discussionmentioning

confidence: 99%

Cytopathologic Characteristics of Epithelioid Vascular Malignancies

et al. 2014

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Objectives: Epithelioid hemangioendothelioma (EHE) and epithelioid angiosarcoma (EAS) are rare vascular neoplasms that share many morphological characteristics on histology but demonstrate different clinical behavior. Given the many reported clinical and morphological features shared between EAS and EHE, we examined all cases of EAS and EHE diagnosed primarily on fine needle aspiration (FNA) at our three institutions that were confirmed by a tissue diagnosis. Study Design: A total of 29 cases from 25 patients were identified: 15 EHE from 11 patients and 14 EAS from 14 patients. Results: Many cytomorphological features existed on a spectrum that overlapped considerably between EAS and EHE cases. Common features between the two entities include epithelioid morphology and eccentrically placed nucleus. Intracytoplasmic lumens (ICL), a morphological feature that may suggest vascular origin, can be found in both entities but are not always present. Conclusions: Given the general absence of vascular cytomorphological features, such as ICL, the proper classification of these tumors depends on the successful use of immunoperoxidase markers such as factor VIII-related antigen, ERG, or CD31 as well as a high index of suspicion. The distinction between EAS and EHE on FNA alone is treacherous at best.

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Section: Discussionmentioning

confidence: 99%

Cytopathologic Characteristics of Epithelioid Vascular Malignancies

et al. 2014

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Mediastinal epithelioid hemangioendothelioma metastatic to lymph nodes and pleural fluid: Report of a case

Antic

Staerkel

2009

Diagnostic Cytopathology

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Epithelioid hemangioendothelioma is a rare mesenchymal tumor of vascular origin, classified as a sarcoma of intermediate malignant potential. Involvement of numerous sites of the body, including visceral organs, soft tissue, testis, skeleton, brain, meninges, and skin have been described. We report an unusual case of a mediastinal epithelioid hemangioendothelioma in a 65-year-old female initially presenting as a metastasis to lymph nodes of the hilar region and subsequently as a malignant pleural effusion. The patient had a complex history of papillary renal cell carcinoma, papillary thyroid carcinoma, and Waldenstrom's hyperglobulinemia making the diagnosis of metastatic epithelioid hemangioendothelioma difficult. Clinical, cytological and immunohistochemical features of this tumor are described with an emphasis on diagnostic pitfalls.

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A case of pulmonary malignant epithelioid hemangioendothelioma misdiagnosed as adenocarcinoma by fine needle aspiration cytology

Ryu

Lee

Choi

et al. 2010

Diagnostic Cytopathology

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Malignant epithelioid hemangioendothelioma (MEHE) is a rare vascular tumor with a biological behavior that lies between those of classical epithelioid hemangioendothelioma and angiosarcoma. Furthermore, MEHE is rarely diagnosed by fine needle aspiration cytology. The authors describe the cytological features of MEHE in a 41-year-old man who presented with increasing dyspnea over a period of 1 month before admission. Computed tomography of the chest showed a 3 cm poorly defined mass in the right lower lobe. Fine needle aspiration cytology demonstrated cellular smears of loosely cohesive clusters of epithelioid cells with numerous intracytoplasmic lumens in a necrotic background. Cellular features included fine chromatin and vesicular or slightly hyperchromatic nuclei with inconspicuous nucleoli and intranuclear inclusions. Nuclear membranes were relatively irregular with indentation. Mean N/C ratio was not increased, presumably due to a moderate amount of cytoplasm. The histologic examination displayed epithelioid and spindle cell proliferation with necrosis accompanying a classical epithelioid hemangioendotheliomatous area. The immunohistochemical evaluation was confirmatory and showed immunoreactivity for vascular markers. The authors also reviewed FNAB findings of epithelioid angiosarcoma, primary adenocarcinoma, and bronchioloalveolar carcinoma of the lung to identify cytomorphologic differences by literature bases. MEHE of the lung is difficult to diagnose cytologically because of its rarity and its cytomorphologic similarities with other malignant epithelial and mesenchymal tumors. However, it may be possible to distinguish it from other entities when the possibility of this unusual vascular neoplasm is suspected and ancillary studies are supportive.

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Pulmonary Epithelioid Hemangioendothelioma

Cited by 17 publications

References 8 publications

Cytopathologic Characteristics of Epithelioid Vascular Malignancies

Cytopathologic Characteristics of Epithelioid Vascular Malignancies

Mediastinal epithelioid hemangioendothelioma metastatic to lymph nodes and pleural fluid: Report of a case

A case of pulmonary malignant epithelioid hemangioendothelioma misdiagnosed as adenocarcinoma by fine needle aspiration cytology

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