Pulmonary Epithelioid Hemangioendothelioma: Radiologic Findings

ABSTRACT

PURPOSE: To describe the computed tomographic (CT) findings and follow-up changes of pulmonary epithelioidhemangioendothelioma (PEH). MATERIALS AND METHODS: The clinical and serial radiological findings [follow-up,5months-5 years (mean, 26.4 months)] of five patients with histologically proven PEH were retrospectivelyreviewed. Three were men and two were women, and they were aged between 25 and 54(mean, 35.6) years. Initial chestradiographs were available in all cases and HRCT, conventional CT and MRI were available in one, respectively.Follow-up conventional CT (n=3) and HRCT (n=2) were performed, and the size, number and distribution of thenodules, calcification and follow-up changes were analyzed. RESULTS: In four patients, chest radiography and CTrevealed bilateral multiple nodules 1-15mm in size. In two patients, the nodules showed interstitial distribution,and one had a single nodule in the right upper lobe. On follow-up CT images, an endobronchial mass withobstructive pneumonitis (n=1) or consolidation with pleural effusion (n=1) was noted. In three patients, thenodules had increased in size and number, and calcification within the nodules was observed in two. CONCLUSION:PEH usually manifests as widespread nodules, sometimes with calcification. Along with larger and increased numbersof nodules, follow-up images of PEH may show an endobronchial mass with obstructive pneumonitis or aconsolidation-like mass with pleural effusion.