Pulmonary epithelioid hemangioendothelioma |
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Authors: | Yoshimasa Mizuno Hisashi Iwata Koyo Shirahashi Yoshinobu Hirose Hirofumi Takemura |
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Institution: | Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan. mizunoyoshidasa@yahoo.co.jp |
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Abstract: | We report two cases of pulmonary epithelioid hemangioendothelioma (PEH). Both patients presented with multiple bilateral pulmonary
nodules, <10 mm diameter, on computed tomography (CT). Multiple pulmonary metastases were considered, but no primary malignant
lesion was detected by other imaging modalities including 18F-fl uorodeoxyglucose positron emission tomography (18F-FDG-PET)/CT. Moreover, the nodules did not show increased uptake of 18F-FDG. We performed pulmonary wedge resections by video-assisted thoracoscopic surgery (VATS). Histological and immunohistochemical
analysis revealed PEH in both. Positivity for the monoclonal antibody MIB-1 in the tumor cells was 5% in the fi rst case and
5%–10% in the second case. Slow tumor progression was detected with CT in the second case. Although 18F-FDG PET/CT is effective for screening other malignant lesions, it does not appear to be of direct use in the diagnosis and
surgical planning of PEH. Pathological diagnosis by VATS is the most effective method. MIB-1 positivity should be analyzed
as to whether it is a prognostic factor of PEH. |
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