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The computed tomographic findings of pulmonary epithelioid hemangioendothelioma

  • Diagnostic Imaging in Oncology
  • Published:
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Abstract

Purpose

The aim of this study is to analyse the computed tomographic (CT) findings of pulmonary epithelioid haemangioendothelioma (EHE).

Materials and methods

The CT features and clinical presentations of six patients (five women, one man; mean age, 53 years) with pathology-proven pulmonary EHE were reviewed. Noncontrast CT images were available for three patients and enhanced CT images for three patients. The image characteristics included the number of tumours, tumour location and size, tumour margins, the presence of calcification/necrosis/cavity, the presence of perivascular location, the presence of pleural lesions, tumour homogeneity at contrast-enhanced CT, tumour enhancement relative to the adjacent muscle and the presence of extrapulmonary lesions.

Results

Multiple nodules/masses with irregular margin were shown in all cases, and reticulonodular opacities and ground-glass opacities were found in one case. Overall, the six cases showed 178 nodules/masses, 90 % (160/178) of which were <1 cm in diameter. The average size of the largest nodules/masses in each case was 2.7 cm. The nodules/masses were mostly (93 %, 166/178) located in the subpleural region (<2 cm from the pleura). A total of 48 % (86/178) of nodules/masses showed punctate calcification in four of six cases. All nodules/masses showed perivascular location. Pleural indentation was shown in all cases, as well as pleural-thickening in five cases and pleural effusion in two cases. On contrast-enhanced CT, EHE showed a mildly heterogeneous hyperdense appearance.

Conclusions

With predilection for subpleural and perivascular location, typical pulmonary EHE appears as multiple irregular nodules with punctate calcification and pleural indentation.

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References

  1. Dail DH, Liebow AA, Gmelich JT et al (1983) Intravascular, bronchiolar, and alveolar tumor of the lung (IVBAT). An analysis of twenty cases of a peculiar sclerosing endothelial tumor. Cancer 51:452–464

    Article  CAS  PubMed  Google Scholar 

  2. Bansal A, Chawla M, Cohen PJ et al (2012) Pleural epithelioid hemangioendothelioma. Lung 190:469–470

    Article  PubMed  Google Scholar 

  3. Crotty EJ, McAdams HP, Erasmus JJ et al (2000) Epithelioid hemangioendothelioma of the pleura: clinical and radiologic features. AJR Am J Roentgenol 175:1545–1549

    Article  CAS  PubMed  Google Scholar 

  4. Kim EY, Kim TS, Han J et al (2011) Thoracic epithelioid hemangioendothelioma: imaging and pathologic features. Acta Radiol 52:161–166

    Article  CAS  PubMed  Google Scholar 

  5. Luburich P, Ayuso MC, Picado C et al (1994) CT of pulmonary epithelioid hemangioendothelioma. J Comput Assist Tomogr 18:562–565

    Article  CAS  PubMed  Google Scholar 

  6. Weiss SW, Enzinger FM (1982) Epithelioid hemangioendothelioma: a vascular tumor often mistaken for a carcinoma. Cancer 50:970–981

    Article  CAS  PubMed  Google Scholar 

  7. Ross GJ, Violi L, Friedman AC et al (1989) Intravascular bronchioloalveolar tumor: CT and pathologic correlation. J Comput Assist Tomogr 13:240–243

    Article  CAS  PubMed  Google Scholar 

  8. Shin MS, Carpenter JT Jr, Ho KJ (1991) Epithelioid hemangioendothelioma: CT manifestations and possible linkage to vinyl chloride exposure. J Comput Assist Tomogr 15:505–507

    Article  CAS  PubMed  Google Scholar 

  9. Ledson MJ, Convery R, Carty A et al (1999) Epithelioid haemangioendothelioma. Thorax 54:560–561

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Mukundan G, Urban BA, Askin FB et al (2000) Pulmonary epithelioid hemangioendothelioma: atypical radiologic findings of a rare tumor with pathologic correlation. J Comput Assist Tomogr 24:719–720

    Article  CAS  PubMed  Google Scholar 

  11. Cronin P, Arenberg D (2004) Pulmonary epithelioid hemangioendothelioma: an unusual case and a review of the literature. Chest 125:789–793

    Article  PubMed  Google Scholar 

  12. Sakamoto N, Adachi S, Monzawa S et al (2005) High resolution CT findings of pulmonary epithelioid hemangioendothelioma: unusual manifestations in 2 cases. J Thorac Imaging 20:236–238

    Article  PubMed  Google Scholar 

  13. Jinghong X, Lirong C (2011) Pulmonary epithelioid hemangioendothelioma accompanied by bilateral multiple calcified nodules in lung. Diagn Pathol 6:21

    Article  PubMed Central  PubMed  Google Scholar 

  14. Rosengarten D, Kramer MR, Amir G et al (2011) Pulmonary epithelioid hemangioendothelioma. Israel Med Assoc J 13:676–679

    Google Scholar 

  15. He M, Das K, Blacksin M et al (2006) A translocation involving the placental growth factor gene is identified in an epithelioid hemangioendothelioma. Cancer Genet Cytogenet 168:150–154

    Article  CAS  PubMed  Google Scholar 

  16. Tanas MR, Sboner A, Oliveira AM et al (2011) Identification of a disease-defining gene fusion in epithelioid hemangioendothelioma. Sci Transl Med 3:98ra82

    Article  PubMed  Google Scholar 

  17. Tsarouha H, Kyriazoglou AI, Ribeiro FR et al (2006) Chromosome analysis and molecular cytogenetic investigations of an epithelioid hemangioendothelioma. Cancer Genet Cytogenet 169:164–168

    Article  CAS  PubMed  Google Scholar 

  18. Amin RM, Hiroshima K, Kokubo T et al (2006) Risk factors and independent predictors of survival in patients with pulmonary epithelioid haemangioendothelioma. Review of the literature and a case report. Respirology 11:818–825

    Article  PubMed  Google Scholar 

  19. Larochelle O, Perigny M, Lagace R et al (2006) Best cases from the AFIP: epithelioid hemangioendothelioma of bone. Radiographics 26:265–270

    Article  PubMed  Google Scholar 

  20. Martinez F, Chung JH, Digumarthy SR et al (2012) Common and uncommon manifestations of Wegener granulomatosis at chest CT: radiologic-pathologic correlation. Radiographics 32:51–69

    Article  PubMed  Google Scholar 

  21. Abramson S, Gilkeson RC, Goldstein JD et al (2001) Benign metastasizing leiomyoma: clinical, imaging, and pathologic correlation. AJR Am J Roentgenol 176:1409–1413

    Article  CAS  PubMed  Google Scholar 

  22. Siegelman SS, Khouri NF, Scott WW Jr et al (1986) Pulmonary hamartoma: CT findings. Radiology 160:313–317

    Article  CAS  PubMed  Google Scholar 

  23. Hirakata K, Nakata H, Nakagawa T (1995) CT of pulmonary metastases with pathological correlation. Semin Ultrasound CT MR 16:379–394

    Article  CAS  PubMed  Google Scholar 

  24. Weiss SW, Ishak KG, Dail DH et al (1986) Epithelioid hemangioendothelioma and related lesions. Semin Diagn Pathol 3:259–287

    CAS  PubMed  Google Scholar 

  25. Chong S, Lee KS, Chung MJ et al (2006) Pneumoconiosis: comparison of imaging and pathologic findings. Radiographics 26:59–77

    Article  PubMed  Google Scholar 

  26. Seo JB, Im JG, Goo JM et al (2001) Atypical pulmonary metastases: spectrum of radiologic findings. Radiographics 21:403–417

    Article  CAS  PubMed  Google Scholar 

  27. Webb WR (1978) The pleural tail sign. Radiology 127:309–313

    Article  CAS  PubMed  Google Scholar 

  28. Bahrami A, Allen TC, Cagle PT (2008) Pulmonary epithelioid hemangioendothelioma mimicking mesothelioma. Pathol Int 58:730–734

    Article  PubMed  Google Scholar 

  29. Lau K, Massad M, Pollak C et al (2011) Clinical patterns and outcome in epithelioid hemangioendothelioma with or without pulmonary involvement: insights from an internet registry in the study of a rare cancer. Chest 140:1312–1318

    Article  PubMed  Google Scholar 

  30. Shang A, Wang X (2009) Pulmonary epithelioid haemangioendothelioma mimicking central lung cancer. Respirology 14:452–455

    Article  PubMed  Google Scholar 

  31. Okamura K, Ohshima T, Nakano R et al (2010) A case of pulmonary epithelioid hemangioendothelioma surviving 10 years without treatment. Ann Thorac Cardiovasc Surg 16:432–435

    PubMed  Google Scholar 

  32. Kitaichi M, Nagai S, Nishimura K et al (1998) Pulmonary epithelioid haemangioendothelioma in 21 patients, including three with partial spontaneous regression. Eur Respir J 12:89–96

    Article  CAS  PubMed  Google Scholar 

  33. Calabro L, Di Giacomo AM, Altomonte M et al (2007) Primary hepatic epithelioid hemangioendothelioma progressively responsive to interferon-alpha: is there room for novel anti-angiogenetic treatments? J Exp Clin Cancer Res 26:145–150

    CAS  PubMed  Google Scholar 

  34. Kim YH, Mishima M, Miyagawa-Hayashino A (2010) Treatment of pulmonary epithelioid hemangioendothelioma with bevacizumab. J Thorac Oncol 5:1107–1108

    Article  PubMed  Google Scholar 

  35. Watanabe S, Yano F, Kita T et al (2008) 18F-FDG-PET/CT as an indicator for resection of pulmonary epithelioid hemangioendothelioma. Ann Nucl Med 22:521–524

    Article  PubMed  Google Scholar 

  36. Chung EM, Lattin GE Jr, Cube R et al (2011) From the archives of the AFIP: pediatric liver masses: radiologic-pathologic correlation. Part 2. Malignant tumors. Radiographics 31:483–507

    Article  PubMed  Google Scholar 

  37. Miller WJ, Dodd GD 3rd, Federle MP et al (1992) Epithelioid hemangioendothelioma of the liver: imaging findings with pathologic correlation. AJR Am J Roentgenol 159:53–57

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

Kefu Liu, Ping Xie, Weijun Peng, Zhengrong Zhou declare no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215008, Jiangsu, China

    Kefu Liu & Ping Xie

  2. Department of Radiology, Fudan University Shanghai Cancer Center, No.270, Dong An Road, Shanghai, 200032, China

    Kefu Liu, Weijun Peng & Zhengrong Zhou

  3. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Kefu Liu, Weijun Peng & Zhengrong Zhou

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  1. Kefu Liu
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  2. Ping Xie
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Correspondence to Kefu Liu.

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Liu, K., Xie, P., Peng, W. et al. The computed tomographic findings of pulmonary epithelioid hemangioendothelioma. Radiol med 119, 705–713 (2014). https://doi.org/10.1007/s11547-013-0376-6

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  • DOI: https://doi.org/10.1007/s11547-013-0376-6

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