Mediastinal epithelioid hemangioendothelioma with abundant spindle cells and osteoclast-like giant cells mimicking malignant fibrous histiocytoma

• Published in: Diagnostic pathology Vol. 8; no. 1; p. 103
• Main Authors: Li, Xiao-Man, Lin, Xu-Yong, Xu, Hong-Tao, Yu, Juan-Han, Wang, Liang, Fan, Chui-Feng, Liu, Yang, Wang, En-Hua
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21.06.2013; BioMed Central
• Subjects: Adult; Biomarkers, Tumor - analysis; Biopsy, Fine-Needle; Care and treatment; Case Report; Chemotherapy; Chemotherapy, Adjuvant; Consent; Diagnosis; Diagnosis, Differential; Giant Cells - chemistry; Giant Cells - pathology; Hemangioendothelioma, Epithelioid - chemistry; Hemangioendothelioma, Epithelioid - pathology; Hemangioendothelioma, Epithelioid - therapy; Histiocytoma, Malignant Fibrous - pathology; Humans; Immune system; Immunohistochemistry; Male; Mediastinal Neoplasms - chemistry; Mediastinal Neoplasms - pathology; Mediastinal Neoplasms - therapy; Mediastinal tumors; Medical imaging; Medical research; Medical treatment; Medicine, Experimental; Osteoclasts - chemistry; Osteoclasts - pathology; Predictive Value of Tests; Shenyang (opera singer); Tomography, X-Ray Computed; Treatment Outcome; Tumors; China
• ISSN: 1746-1596; 1746-1596
• DOI: 10.1186/1746-1596-8-103

Epithelioid hemangioendothelioma is a relatively uncommon lesion usually presenting in soft tissues. The occurrence in the mediastinum is exceptional rare. Histologically, this tumor is characterized by epithelioid cells with intracytoplasmic vacuoles in a hyalinized or mucinous stroma. Occasionally, spindle cells or osteoclast-like giant cells can be observed. Herein, we present a case of epithelioid hemangioendothelioma in a 38 year-old Chinese male. The tumor was predominantly composed of abundant spindle cells with marked atypia and scattered osteoclast-like giant cells reminiscent of malignant fibrous histiocytoma. The unusual histological appearance can pose a great diagnostic challenge. It may be easily misdiagnosed, especially if the specimen is limited or from fine-needle aspiration.