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Hepatic epithelioid hemangioendothelioma: A diagnostic pitfall in aspiration cytology.

Gupta R, Mathur SR, Gupta SD, Durgapal P, Iyer VK, Das CJ - Cytojournal (2010)

Bottom Line: We describe a case of a young healthy adult male who was found to have multiple hepatic masses on radiologic investigations.He is doing well 14 months after diagnosis, without surgical excision or chemotherapy.Since this tumor is usually unresectable but has a favorable prognosis as compared to hepatocellular carcinoma, a correct diagnosis is essential for appropriate management and prognostication.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Hepatic epithelioid hemangioendothelioma (EH) is a rare vascular neoplasm. An accurate radiologic diagnosis is usually difficult due to the presence of multiple nodules, simulating metastatic carcinoma. Though histologic features of this tumor are well described, cytologic reports of hepatic EH are very few in the available literature. We describe a case of a young healthy adult male who was found to have multiple hepatic masses on radiologic investigations. A guided fine needle aspiration demonstrated a poorly differentiated neoplasm. The diagnosis was made on core biopsy assisted by immunohistochemistry, which showed characteristic features of EH. He is doing well 14 months after diagnosis, without surgical excision or chemotherapy. An accurate diagnosis of hepatic EH on aspiration cytology requires an adequate specimen and awareness of its cytologic features, including discohesive atypical cells with intracytoplasmic lumina and intranuclear inclusions. Since this tumor is usually unresectable but has a favorable prognosis as compared to hepatocellular carcinoma, a correct diagnosis is essential for appropriate management and prognostication.

No MeSH data available.


Related in: MedlinePlus

MRI images (T1-weighted) showing a diffuse poorly defined hypointense mass in right and left lobes of liver with subcapsular retraction (a). The mass is hyperintense on T2-weighted image (b)
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Figure 0001: MRI images (T1-weighted) showing a diffuse poorly defined hypointense mass in right and left lobes of liver with subcapsular retraction (a). The mass is hyperintense on T2-weighted image (b)

Mentions: Contrast-enhanced computed tomography (CECT) scan showed hepatomegaly, more in the left lobe than the right lobe with heterogeneous attenuation and variegated enhancement of right lobe. Magnetic resonance imaging (MRI) confirmed the findings of CECT with ill-defined space-occupying lesions involving both lobes of liver. The mass lesions were hypointense on T1-weighted images and hyperintense on T2-weighted images [Figure 1].


Hepatic epithelioid hemangioendothelioma: A diagnostic pitfall in aspiration cytology.

Gupta R, Mathur SR, Gupta SD, Durgapal P, Iyer VK, Das CJ - Cytojournal (2010)

MRI images (T1-weighted) showing a diffuse poorly defined hypointense mass in right and left lobes of liver with subcapsular retraction (a). The mass is hyperintense on T2-weighted image (b)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822180&req=5

Figure 0001: MRI images (T1-weighted) showing a diffuse poorly defined hypointense mass in right and left lobes of liver with subcapsular retraction (a). The mass is hyperintense on T2-weighted image (b)
Mentions: Contrast-enhanced computed tomography (CECT) scan showed hepatomegaly, more in the left lobe than the right lobe with heterogeneous attenuation and variegated enhancement of right lobe. Magnetic resonance imaging (MRI) confirmed the findings of CECT with ill-defined space-occupying lesions involving both lobes of liver. The mass lesions were hypointense on T1-weighted images and hyperintense on T2-weighted images [Figure 1].

Bottom Line: We describe a case of a young healthy adult male who was found to have multiple hepatic masses on radiologic investigations.He is doing well 14 months after diagnosis, without surgical excision or chemotherapy.Since this tumor is usually unresectable but has a favorable prognosis as compared to hepatocellular carcinoma, a correct diagnosis is essential for appropriate management and prognostication.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

ABSTRACT
Hepatic epithelioid hemangioendothelioma (EH) is a rare vascular neoplasm. An accurate radiologic diagnosis is usually difficult due to the presence of multiple nodules, simulating metastatic carcinoma. Though histologic features of this tumor are well described, cytologic reports of hepatic EH are very few in the available literature. We describe a case of a young healthy adult male who was found to have multiple hepatic masses on radiologic investigations. A guided fine needle aspiration demonstrated a poorly differentiated neoplasm. The diagnosis was made on core biopsy assisted by immunohistochemistry, which showed characteristic features of EH. He is doing well 14 months after diagnosis, without surgical excision or chemotherapy. An accurate diagnosis of hepatic EH on aspiration cytology requires an adequate specimen and awareness of its cytologic features, including discohesive atypical cells with intracytoplasmic lumina and intranuclear inclusions. Since this tumor is usually unresectable but has a favorable prognosis as compared to hepatocellular carcinoma, a correct diagnosis is essential for appropriate management and prognostication.

No MeSH data available.


Related in: MedlinePlus