Case Number : Case 903 - 4th December Posted By: Guest

[font="StoneSerif"][size="1"][font="StoneSerif"][size="1"]Epithelioid hemangioendothelioma[/size][/font][/size][/font]

Epithelioid sarcoma.

Angiosarcoma

agree [font=StoneSerif][size=1][size=1]Epithelioid hemangioendothelioma[/size][/size][/font]

Epithelioid hemangioendothelioma. Don´t see malignant features here.

Epithelioid angiosarcoma

Epithelioid hemangioendothelioma

Epitheloid Sarcoma.
suggested IHC panel ;CK, CD34, iNI1

Except for the lower power view all images show us an epithelioid vascular neoplasia. There are not obvious signs of malignancy so I think epithelioid angiosarcoma can be excluded. Although I cannot see eosinophils there are some lymphocytes in the last figure and the well formed vessels seen in figure 4 are not a characteristic of epithelioid hemangioendotheliomas. So, I think this is an epithelioid hemangioma.

Intratumoral extravasated erythrocytes make me think of vascular tumor. In the face of lacking brisk mitotic activity within solid sheets of epithelioid cells with intracytoplasmic lumens, I go with epithelioid hemangioendothelioma.

Epithelioid hemangioma.

The vascular spaces in the 4th image as Romualdo said are not seen in EHE. I am also thinking of epithelioid hemangioma, may be esinophils are present elsewhere!!!!! I am a bit puzzled with the first image, could it be an intravascular epithelioid hemangioma???

Epitheliod hemangioendothelioma

[size=4][font=arial,helvetica,sans-serif]I agree with epithelioid hemangioendothelioma vs. hemangioma. The atypia level and mitotic level is low, so doubt angiosarcoma or epithelioid sarcoma.

[i]Other differential diagnosis considerations:[/i][/font][/size]
[font=arial,helvetica,sans-serif][size=4]1. Retiform hemangioendothelioma has curvilinear arcuate vessels with hobnailing, and collagenous fibrosis, but not the solid areas, seen in these images. The clinical presentation (extremity of adult) would be supportive.
2. Masson's tumor (intravascular epithelial hyperplasia), would be in the differential for a low-grade vascular proliferation lacking significant mitotic activity. Clinical history (hand lesion, middle-age female) would be a very common presentation.
3. Kaposi's sarcoma. [/size][/font]

[color=#1C2837][font=arial, verdana, tahoma, sans-serif][size=4]Epithelioid hemangioendothelioma[/size][/font][/color]

Epitheid sarcoma-lke hemangioendthelioma is agood posibiliy here.

I called this epithelioid hemangioendothelioma.