1995 Volume 34 Issue 4 Pages 722-727
Epithelioid hemangioendothelioma is a distinctive vascular tumor often arising from a vessel. This rare tumor is characterized by epithelioid endothelial cells with cytoplasmic vacuolation.
The term was first used by Weiss and Enzinger on 1982.
We recently experienced a case of epithelioid hemangioendothelioma of the soft tissue. The patient was a 60-year-old woman with a 3×3×2 cm mass in her left axilla.
Tumor cells were cytologically characterized by epithelioid cell clusters in papillary or sheet like configurations. The cellular morphology varied from oval to polygonal. These cells were stained light-green and had cytoplasmic vacuoles which occasionally included red blood cells. The cytoplasmic vacuoles varied in size from small to large. The small vacuoles looked like intracytoplasmic lumina (ICL) while the large vacuoles looked like signet-ring cell carcinoma. The nuclear shapes were round to oval. The nuclei were characterized by grooves and intracytoplasmic inclusion or vacuole like structures. The nuclear chromatin pattern was fine granular with 1 to 2 small nucleoli. Mitosis was not recognized. The background was clean and there were few red blood cells. The tumor cells stained positive immunohistochemically for factor VIII related antigen in cytological material. We propose that the characteristics of epithelioid hemangioendothelioma cells include cytoplasmic vacuolation and intracytoplasmic nuclear inclusion like structures, and that these cytological findings are very useful for distinguishing this rare tumor from other tumors resemble it.
