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Table of Contents
Definition / general | Radiology description | Prognostic factors | Case reports | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosis | Additional referencesCite this page: Epithelioid hemangioendothelioma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/boneehe.html. Accessed July 14th, 2017.
Definition / general
- Inconsistent use by pathologists - some include epithelioid hemangioma or angiosarcoma
- Better use is to define as borderline or low grade malignancy affecting bone, soft tissue, liver, lung
- Rare tumor
- 22 - 55% are multicentric, may be associated with nearby skin or soft tissue lesions
- Associated with pain
- Sites: femur, occasionally vertebrae
Radiology description
- Osteolytic appearance without bony expansion, may have peripheral sclerosis
- Infiltration is associated with higher grade lesions
Prognostic factors
- Poor
- Visceral involvement
Case reports
- 17 year old girl with lytic lesion in the vertebra (Arch Pathol Lab Med 2001;125:1611)
Treatment
- Surgical excision, may respond to radiation therapy
Microscopic (histologic) description
- Cohesive growth pattern of cells with eosinophilic and often cytoplasmic vacuolization, some vacuoles contain erythrocytes
- Vesicular nuclei, some with prominent grooves, mild atypia
- Recent and old hemorrhage
- Variable eosinophils, vasoformative features may be primitive and accompanied by myxohyaline stroma
- No / rare mitotic activity, no anastomosing channels
Microscopic (histologic) images
Images hosted on other servers:
Epithelioid cells with cytoplasmic vacuoles
Positive stains
Negative stains
- Mucin (Alcian blue, mucicarmine, PAS), S100, cytokeratin
Differential diagnosis
- Chordoma: destructive lobulated pattern and multivacuolated physaliferous cells, keratin+, S100+
- Epithelioid hemangioma: well formed vascular spaces
- Metastatic carcinoma
Additional references
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