Key result
Cytologic evaluation and immunocytochemical staining for Ulex Europaeus, Factor VIII-related antigen, and CD34 confirmed the diagnosis of metastatic epithelioid hemangioendothelioma.
Case Report (n=1)
Cytologic features combined with immunocytochemical staining can successfully diagnose metastatic epithelioid hemangioendothelioma in pleural effusions.
May aid cytologic diagnosis of rare tumors in effusions; hypothesis-generating and requires validation before practice change.
Epithelioid hemangioendothelioma (EH) is a vascular neoplasm of uncertain malignant potential. We report a 22-yr-old female with a primary malignant EH of the iliac bone with adjacent soft tissue involvement which, during its metastatic course, presented as a pleural effusion. The effusion was cellular with tumor cells present both singly and in clusters. Distinguishing cytologic features included cytoplasmic vacuolization consistent with primitive intracytoplasmic lumen formation, variability in cell size, biphasic cytoplasmic staining with Diff-Quik stain, multinucleation, cell in cell engulfment, and multiple prominent nucleoli. Differential diagnosis based on morphology included malignant mesothelioma and adenocarcinoma. Immunocytochemical stains on the neoplastic cells were positive for Ulex Europaeus, Factor VIII-related antigen, and CD34, reflecting vascular differentiation and confirming the diagnosis of metastatic EH to the pleural cavity.
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Abati et al. (1994) conducted a case report in Metastatic epithelioid hemangioendothelioma (n=1). Cytologic and immunocytochemical evaluation was evaluated on Diagnosis of metastatic epithelioid hemangioendothelioma. Cytologic evaluation and immunocytochemical staining for Ulex Europaeus, Factor VIII-related antigen, and CD34 confirmed the diagnosis of metastatic epithelioid hemangioendothelioma.