van Kasteren M E, van der Wurff A A, Palmen F M, Dolman A, Miseré J F
Dept of Internal Medicine, St. Elisabeth Hospital, Tilburg, The Netherlands.
Eur Respir J. 1995 Sep;8(9):1616-9.
In 1973, a 10 year old boy presented with numerous bilateral lung nodules, diagnosed as histiocytosis X by open lung biopsy. The patient was treated with prednisone until 1984. In 1993, he developed severe pain in the neck. A biopsy of the spine revealed the same tumour morphology as was seen in the lung in 1973. Immunohistological examination of the former and present biopsy led to the definitive diagnosis of epithelioid haemangioendothelioma of the lung with metastases to spine and liver. Epithelioid haemangioendothelioma of the lung is a rare soft tissue tumour of vascular origin, readily mistaken for carcinoma or, as in this case, histiocytosis. The tumour has an intermediate malignant potential. Although metastases of epithelioid haemangioendothelioma of the lung are well-known, metastatic spread to bones, as in our case, has not previously been mentioned in the literature.
1973年，一名10岁男孩出现大量双侧肺结节，经开胸肺活检诊断为组织细胞增多症X。该患者接受泼尼松治疗直至1984年。1993年，他出现颈部剧痛。脊柱活检显示肿瘤形态与1973年在肺部所见相同。对之前和现在的活检组织进行免疫组织学检查后，最终诊断为肺上皮样血管内皮瘤伴脊柱和肝脏转移。肺上皮样血管内皮瘤是一种罕见的起源于血管的软组织肿瘤，很容易被误诊为癌，或者在本病例中被误诊为组织细胞增多症。该肿瘤具有中等恶性潜能。虽然肺上皮样血管内皮瘤的转移很常见，但像我们病例中转移至骨骼的情况，此前文献中尚未提及。
