Carretero Antonio, Elmberger P Göran, Sköld C Magnus, Collins Brian T
Department of Clinical Cytology, Karolinska Hospital, Stockholm, Sweden.
Acta Cytol. 2006 Jul-Aug;50(4):455-9. doi: 10.1159/000325992.
Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low grade, malignant vascular tumor that typically presents with multiple pulmonary nodules in young women. This report details the cytopathologic and pathologic findings in an unusual case presenting in an older male with a pleural effusion, dominant nodule and multiple bilateral infiltrates.
A 62-year-old, male nonsmoker was referred due to increasing dyspnea. Chest radiography revealed a pleural effusion and nodular infiltrate in the right upper lobe of the bronchus. Thoracocentesis and thoracoscopy were performed, with a pleural drain inserted. Bronchoscopy revealed a right upper lobe bronchus occluded by a greyish, necrotic mass. Various cytopathologic sampling techniques, including fine needle aspiration biopsy, as well as traditional histopathologic biopsies were performed. Cytologic specimens showed loosely cohesive, epithelioid cells that were binucleated and multinucleated. Chromatin was granular, with scattered, small, multiple nucleoli with occasional, variably sized cytoplasmic vacuoles. The patient's condition deteriorated, and he died 3 weeks after admission.
Pulmonary epithelioid hemangioendotheliomas are unusual neoplasms with a epithelioid, discohesive cellular appearance. It can mimic other, more commonly seen pulmonary neoplasms. Careful attention to cytomorphologic features and application of ancillary studies assist in making the diagnosis.
肺上皮样血管内皮瘤（PEH）是一种罕见的、低级别恶性血管肿瘤，通常在年轻女性中表现为多个肺结节。本报告详细描述了一例不寻常病例的细胞病理学和病理学发现，该病例发生在一名老年男性身上，表现为胸腔积液、优势结节和双侧多发浸润。
一名62岁不吸烟男性因呼吸困难加重前来就诊。胸部X线检查显示右侧支气管上叶有胸腔积液和结节状浸润。进行了胸腔穿刺和胸腔镜检查，并插入了胸腔引流管。支气管镜检查显示右上叶支气管被灰白色坏死肿物阻塞。采用了多种细胞病理学采样技术，包括细针穿刺活检以及传统组织病理学活检。细胞学标本显示细胞松散黏附，为上皮样细胞，可见双核和多核。染色质呈颗粒状，有散在的小核仁，多个核仁大小不一，偶尔可见大小不等的胞质空泡。患者病情恶化，入院3周后死亡。
肺上皮样血管内皮瘤是一种不寻常的肿瘤，具有上皮样、细胞不黏附的外观。它可模仿其他更常见的肺肿瘤。仔细关注细胞形态学特征并应用辅助检查有助于做出诊断。
