Epithelioid Hemangioendothelioma of the Lung: Report of a case

Kang, Gyeong Hoon; Kim, Yong Il; Han, Sung Koo; Shim, Young Soo; Ham, Eui Keun; Lee, Sang Kook; Lee, Sang Sook

Abstract

Intravascular bronchioloaveolar tumor is now recognized as a pulmonary form of epithelioid hemangioendothelioma, being manifested with bilateral multiple pulmonary nodules in young women. This 34-year-old woman received two occasions of open lung biopsies with interval of 1 year for diffuse nodular infiltrations in both lung fields. Repeated radiographic study 3 year later showed no significant progression of the pulmonary nodular lesions except for pleural effusion. Two occasions of open lung biopsies disclosed similar multiple discrete nodules which consisted of central acellular areas with lacuna-like ghosts and peripheral cellular zone. The tumor cells grew in micropolypoid fashion with preservation of background alveolar frame-works. Ultrastructure disclosed most of neoplastic cells presenting with the features suggestive of endothelial differentiation, and immunohistochemical study revealed the presence of cellular areas which gave positive reaction to factor VIII-related antigen. We support that this is an additional case of epithelioid hemangioendothelioma of the lung that is manifested with a multicetric intrapulmonary vascular endothelial cell growth featuring a vasoformative tendency and participation of topography-specific histologic modification.