Pulmonary epithelioid hemangioendothelioma mimicking mesothelioma

Armita Bahrami, Timothy C. Allen, Philip T. Cagle

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

An intrathoracic mass was discovered on magnetic resonance imaging (MRI) of the spine in a 37-year-old Caucasian man with a 1 year history of progressively severe upper back pain. A subsequent chest CT scan indicated a 4 cm left hilar mass, extending to the apex and encasing a portion of the left bronchus and pulmonary artery. Initial bronchoscopic and transthoracic biopsies failed to obtain diagnostic material. The patient underwent thoracotomy and was found to have a locally advanced, surgically unresectable lung tumor, involving the pleura, pericardium and diaphragm. The patient failed to respond to radiochemotherapy, and died 11 months following the diagnosis with tamponade and metastasis to the skin of the thoracoabdominal wall. Histologically the tumor had an epithelioid and spindled appearance, without high-grade histological features, and was initially thought to represent biphasic diffuse malignant mesothelioma. Positive immunohistochemistry for vascular markers (CD31, CD34, and FLI-1) disclosed the vascular nature of the tumor. Mesothelioma markers were universally negative and cytokeratin was focally reactive only in some epithelioid cells. Epithelioid hemangioendothelioma is a rare tumor in the lung that can mimic other more common pathological entities, and should be included in the differential diagnosis of unusual pulmonary neoplasms with epithelioid or biphasic morphology.

Original languageEnglish (US)
Pages (from-to)730-734
Number of pages5
JournalPathology International
Volume58
Issue number11
DOIs
StatePublished - Nov 2008
Externally publishedYes

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Epithelioid Hemangioendothelioma
Mesothelioma
Lung
Blood Vessels
Neoplasms
Epithelioid Cells
Pleura
Pericardium
Chemoradiotherapy
Thoracotomy
Bronchi
Back Pain
Keratins
Diaphragm
Pulmonary Artery
Lung Neoplasms
Spine
Differential Diagnosis
Thorax
Immunohistochemistry

Keywords

  • Angiosarcoma
  • Epithelioid hemangioendothelioma
  • Mesothelioma mimickers
  • Pulmonary neoplasms
  • Vascular markers

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Pulmonary epithelioid hemangioendothelioma mimicking mesothelioma. / Bahrami, Armita; Allen, Timothy C.; Cagle, Philip T.

In: Pathology International, Vol. 58, No. 11, 11.2008, p. 730-734.

Research output: Contribution to journalArticle

Bahrami, Armita ; Allen, Timothy C. ; Cagle, Philip T. / Pulmonary epithelioid hemangioendothelioma mimicking mesothelioma. In: Pathology International. 2008 ; Vol. 58, No. 11. pp. 730-734.
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