Chen Tong, Sun Yapeng, Zeng Mengsu, Wang Mingliang
Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China.
Department of Radiology, The Second Affiliated Hospital of Soochow University, Suzhou 215000, China.
Curr Med Imaging. 2025;21:e15734056360811. doi: 10.2174/0115734056360811250516114535.
Epithelioid Hemangioendothelioma (EHE) is a rare vascular neoplasm that typically occurs in the bone, soft tissue, liver, and lung but rarely in the mediastinum. Multimodal imaging of EHE is poorly understood, often leading to misdiagnosis as other mediastinal tumors.
Two female cases with incidental mediastinal masses were retrospectively analysed, focusing on multimodal presentations. For both cases, CT studies showed well-defined, low-density oval masses in the right anterior superior mediastinum with the Superior Vena Cava (SVC) invasion. Intralesional punctate calcifications were observed in Case 2. MRI revealed hypointense masses on T1WI and slightly hyperintense on T2WI, with partial diffusion restriction on DWI. Case 1 had mild enhancement, while Case 2 had significant enhancement. PET-CT showed significant FDG uptake with maximum standardized uptake values (SUVmax) of 9.2 and 5.1, respectively. Both patients underwent surgical resection, with pathology confirming mediastinal EHEs.
Mediastinal EHE presents as a well-defined soft-tissue mass with punctate calcifications and heterogeneous enhancement, typically located in the anterior mediastinum with invasion into medium or large veins. Moreover, it should be considered in the differential diagnosis of mediastinal tumors.
上皮样血管内皮瘤（EHE）是一种罕见的血管肿瘤，通常发生于骨骼、软组织、肝脏和肺部，但很少发生于纵隔。EHE的多模态影像学表现尚不清楚，常导致误诊为其他纵隔肿瘤。
回顾性分析两例偶然发现纵隔肿块的女性病例，重点关注多模态表现。两例病例的CT检查均显示右前上纵隔有边界清晰的低密度椭圆形肿块，侵犯上腔静脉（SVC）。病例2可见病灶内点状钙化。MRI显示肿块在T1WI上呈低信号，在T2WI上呈轻度高信号，在DWI上有部分扩散受限。病例1有轻度强化，病例2有显著强化。PET-CT显示明显的FDG摄取，最大标准化摄取值（SUVmax）分别为9.2和5.1。两名患者均接受了手术切除，病理证实为纵隔EHE。
纵隔EHE表现为边界清晰的软组织肿块，伴有点状钙化和不均匀强化，通常位于前纵隔并侵犯中或大静脉。此外，在纵隔肿瘤的鉴别诊断中应考虑到该病。
