1999 Volume 38 Issue 4 Pages 352-357
Background: Epithelioid hemangioendothelioma (EH) is a low-grade malignant tumor of vascular origin. Common sites of occurrence include soft tissue, bone, lung, and liver. Because of its resemblance to epithelial tumors, the tumor may be misdiagnosed as a metastatic carcinoma. A case of EH of bone is presented and the results of cytological, histological, immunohistochemical, and ultrastructural studies are described.
Case: A 73-year-old woman was admitted to our hospital for further examination of a tumorous lesion in her left fibula. Distinguishing cytological features included cytoplasmic vacuolation consistent with primitive intracytoplasmic vascular formation. Histologically, two types of tumor cells were identified. Either spindle-shaped cells were dispersed in abundant myxomatous or collagenous stroma, or polygonal epithelioid cells were arrnged in nests. Immunohistochemically, both types of tumor cells reacted with anti-Factor VIII-related antigen, CD 34, and Ulex europaeus antibodies. Electron microscopy and immunohistochemical studies proved the endothelial nature of the epithelioidappearing cells of the neoplasm
Conclusion: The cytological feature of an epithelioid appearance with cytoplasmic vacuolation seems to be an important finding to suggest EH in imprint smear.
