Pulmonary epithelioid hemangioendothelioma: A case of computed-tomography diagnostic analysis and follow-up

Pulmonary epithelioid hemangioendothelioma: A case of computedtomography diagnostic analysis and follow-upTo the Editor, Epithelioid hemangioendothelioma is a rare, low-grade malignant tumor of vascular origin 1,2 , which may occur in all organs of the body.However, the incidence of pulmonary epithelioid hemangioendothelioma (PEHE) is very rare.3e5 A 27-year-old female patient was found to have diffused nodular foci in the bilateral lungs by physical examination.The respiratory motion of the bilateral lungs was symmetrical, with clear percussive sounds.There were coarse breathing sounds in the bilateral lungs and no obvious dry or wet rales.Results of the plain and enhanced CT scans of the chest (Fig. 1AeF): There existed diffused distribution of nodular hyperintensities in the bilateral lungs, mainly in the subpleural areas, with more nodules in the lower lobe than in the upper lobe of the bilateral lungs.The margins of most nodules were smooth and clear.The margins of the nodules in the area near the pleura were unclear, with shallow lobes and fusion in some nodules, and there was no spicule sign visible.Multiple pleural adhesions and thickening changes were observed, with a small amount of pleural effusion in the interlobular fissure.Larger nodules were visible in the mediastinal window, while the smaller ones were not visible.A CTguided percutaneous lung biopsy was conducted to clarify the pathology.The punctured pulmonary tissues sent for examination were seven pieces of grayish-white thread-like tissues with a length of 0.4e1 cm and a diameter of 0.1 cm.In the hematoxylin and eosin staining, the tumor cells were observed in the alveolar