EpithelioidHemangioendothelioma of the Liver: Case Repor

Overview

Epitheliolid hemanigoendothelioma of the liver is a very rare vascular tumor. We report the caseof this tumor found during the autopsy of a 74-year-old man. The liver was infiltrated by multiplegreyish nodes (diam. 3-30 mm), partially calcified. Microscopically, the tumor was composed ofdense sclerotic and fibrous stroma with focal calcifications. In this stroma, groups and cords ofirregular cells of two main types were dispersed. The first type was represented by big cells withlarge clear eosinophilic cytoplasm. The second cell type was characterised by medium-sized elongated, sometimes bizarre-shaped cells. Tumorous cells did not produce mucin. Immunohistochemically, the tumorous cells were positive for FVIIIR - Ag, actin, vimentin, and desmin and alsoshowed disperse weak positivity for S100 protein. Staining for epithelial membrane antigene(EMA), keratins, and CD68 was negative. Neoplastic cells were positive for Ulex europaeus lectin.Electronmicroscopically, the tumorous cells had irregular nuclei, lobular or cleft shape with oneor two nucleoli. Cytoplasm contained a high amount of intermediate filaments forming largeaggregates. The cells were connected by desmosomes and partially surrounded by dense basallamina. The diagnosis of epithelioid hemangioendothelioma is based on a histological picture,supported by immunohistochemical positivity for FVIIIR: Ag and Ulex europaeus and by additional ultrastructural study.

Key words:
Key words: epithelioid hemangioendothelioma - liver - electron microscopy - immunohistochemis-try