Malignant pleuropulmonary epithelioid hemangioendothelioma - unusual presentation of an aggressive angiogenic neoplasm.

Epithelioid hemangioendothelioma (EHE) of the lung and pleura are rare tumors. Primary pleural EHE are associated with aggressive behavior and poor clinical outcome. Recent advances in EHE include the development of immunohistochemical markers of vascular differentiation, namely Fli-1, and the identification of a specific chromosomal translocation (t(1;3)(p36;q25)). We present a 19 year old male patient with a rapidly progressive malignant neoplasm that presented as a multinodular lung parenchymal process, with associated pleural effusion and thickening. Pathologic examination revealed a pleuropulmonary neoplasm with cytologic features including round to oval epithelioid cells with frequent cytoplasmic vacuoles. Immunohistochemistry confirmed vascular differentiation of tumor cells (CD34, CD31 and Fli-1 positive). While the cytologic features were suggestive of EHE, the aggressive nature of the neoplasm, with disseminated pleuropulmonary involvement, raised the question of whether the neoplasm should be classified as EHE or epithelioid angiosarcoma. Here, we review the clinicopathologic characteristics of pleuropulmonary EHE and the overlap between malignant EHE and angiosarcoma.

Oncocytoma of the parotid gland: a case report and review of the literature.

We report the case of a patient who presented to the ENT service with left facial swelling of 5 months duration. Imaging studies revealed a dense expansive mass confined to the inside of the left deep parotid lobule and moderate enhancement following contrast media injection. Subsequently, a biopsy confirmed the presence of an oncocytoma. The patient was treated with total parotidectomy, complete tumor resection and sparing facial nerve surgery. Today, the patient is disease free and has no complications.

Inflammatory fibroid polyp associated with early gastric carcinoma: a case report.

Inflammatory fibroid polyp (IFP) is a rare mesenchymal lesion of the gastrointestinal tract. The association of IFP with gastric carcinoma has been only reported in 7 previously published cases. We present the case of a 69-year-old man who underwent gastrectomy because of an early gastric carcinoma invading the submucosa with an underlying IFP, which pushed the neoplastic surface to the gastric lumen in a polypoid fashion. The IFP revealed a CD34-positive spindle cell proliferation surrounding blood vessels in a concentric way and covered by carcinomatous glands. The patient is free of disease after 108 months of follow-up. The underlying spindle cell proliferation and blood vessels may be reactive to malignant glands found in the surface, although recent molecular analyses support the neoplastic nature of this lesion.