Department of Medical Imaging, Changhua Christian Hospital, Changhua, Taiwan.
Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.
BMJ Case Rep. 2023 Sep 14;16(9):e254915. doi: 10.1136/bcr-2023-254915.
Pulmonary epithelioid hemangioendothelioma (PEH) is a rare tumour of vascular origin with low to intermediate malignancy. Typical radiological finding on CT is multiple small nodules in bilateral lungs, and some will have punctate calcifications and pleural thickening. The diagnosis of PEH is confirmed by histopathological findings and positive immunohistochemistry staining. We report a case of a woman in her 50s with a medical history of lung adenocarcinoma. Later, regular chest CT during a routine cancer follow-up revealed multiple small pulmonary nodules and increased sizes of these nodules on serial images, initially misdiagnosed as multiple lung metastases. The histopathological diagnosis was made on a pulmonary wedge resection. Finally, PEH was diagnosed on the basis of positive immunohistochemical staining for CD31, ERF and TFE3. In the current study, the clinicopathological features and review of the literature were investigated. Our case highlights the importance of a histological diagnosis to avoid misdiagnosis.
肺上皮样血管内皮细胞瘤（PEH）是一种起源于血管的罕见肿瘤，恶性程度低至中等。CT 上的典型放射学表现是双肺多发小结节，部分会有点状钙化和胸膜增厚。PEH 的诊断通过组织病理学发现和阳性免疫组织化学染色来确认。我们报告了一例 50 多岁女性的病例，该患者有肺腺癌病史。后来，在常规癌症随访期间定期进行胸部 CT 检查，显示多个小结节和这些结节在连续图像上的大小增加，最初误诊为多发性肺转移。通过肺楔形切除术进行了组织病理学诊断。最后，基于 CD31、ERF 和 TFE3 的阳性免疫组织化学染色，诊断为 PEH。在目前的研究中，我们调查了其临床病理特征和文献复习。我们的病例强调了组织学诊断的重要性，以避免误诊。
