Thoracic epithelioid hemangioendothelioma: imaging and pathologic features

Area of Science:

• Radiology
• Pathology
• Oncology

Background:

• Epithelioid hemangioendotheliomas are rare vascular tumors.
• Thoracic involvement is infrequent but presents distinct imaging patterns.
• Accurate diagnosis relies on integrating imaging and pathology.

Purpose of the Study:

• To review and correlate the imaging features of thoracic epithelioid hemangioendotheliomas.
• To describe the characteristic computed tomography (CT) patterns.
• To highlight key features differentiating these tumors.

Main Methods:

• Review of imaging findings in pathologically confirmed cases.
• Correlation of computed tomography (CT) patterns with histopathological diagnoses.
• Analysis of characteristic imaging features associated with malignancy.

Main Results:

• Thoracic epithelioid hemangioendotheliomas exhibit three primary CT patterns: multiple pulmonary nodules, reticulonodular opacities, or pleural thickening.
• Malignant features such as multiple nodules, hepatic/bone involvement, and lymphangitic spread are noted.
• These features can be present without histological evidence of malignancy.

Conclusions:

• Imaging plays a crucial role in identifying thoracic epithelioid hemangioendotheliomas.
• Recognizing specific CT patterns and associated malignant features is key for diagnosis.
• Pathologic correlation is essential for definitive characterization.