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Pulmonary epithelioid hemangioendothelioma
Yoshimasa Mizuno1, Hisashi Iwata, Koyo Shirahashi
1Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan. mizunoyoshidasa@yahoo.co.jp
General Thoracic and Cardiovascular Surgery
|April 13, 2011
Summary
Pulmonary epithelioid hemangioendothelioma (PEH) presents as multiple small nodules. Diagnosis requires pathological analysis via video-assisted thoracoscopic surgery (VATS), as imaging like (18)F-FDG PET/CT is not definitive for PEH.
Area of Science:
- Pulmonology
- Oncology
- Pathology
Background:
- Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor.
- Diagnosis can be challenging due to nonspecific presentation.
Observation:
- Two patients presented with multiple bilateral pulmonary nodules (<10 mm) on CT.
- No primary malignancy or increased (18)F-FDG uptake was detected by PET/CT.
- Pulmonary wedge resections were performed via video-assisted thoracoscopic surgery (VATS).
Findings:
- Histological and immunohistochemical analysis confirmed PEH in both cases.
- MIB-1 positivity ranged from 5% to 10% in tumor cells.
- Slow tumor progression was observed in one patient.
Implications:
- (18)F-FDG PET/CT is not directly useful for PEH diagnosis or surgical planning.
- VATS with pathological diagnosis remains the gold standard for PEH identification.
- Further research is needed to determine if MIB-1 positivity is a prognostic factor for PEH.
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