Increased FDG uptake in pulmonary epitheloid hemangioendothelioma

doi:10.1157/13088416

Revista Española de Medicina Nuclear

Volume 25, Issue 3, June 2006, Pages 188-192

https://doi.org/10.1157/13088416 Get rights and content

Abstract

A 40 year-old female was examinated for complaints of left arm pain and restriction of movement in the left upper extremity for 3 months. Chest X-ray showed a mass in the left upper lung and the patient was evaluated with computed tomography that confirmed the significant mass in the left paratracheal region and also showed small nodules in both of the lungs. A whole-body FDG-PET scan was performed for the suspicion of malignancy. FDG-PET indicated high FDG accumulation in the lung lesions mainly in the left paratracheal region. FDG-PET findings were highly suspicious of malignancy so the patient had thoracoscopic biopsy of the lesion. The histological findings and imunohistochemistry tests were consistent with pulmonary epitheloid hemangioendothelioma (PEH). Epitheloid hemangioendothelioma (EH) is a systemic name that represents a rare type of malignant tumor of vascular endothelial origin, which can arise in bone, liver, soft-tissue, or lung. PEH is currently known as the lung form of EH. Consequently, our patient had resection of the left paratracheal mass.

This report presents a rare case of histologically confirmed PEH, which showed increased FDG accumulation on FDGPET study. PEH should be added to the other causes of increased FDG uptake.

Resumen

Examinamos a una mujer de 40 años de edad, que llevaba tres meses quejándose de dolor en su brazo izquierdo y de restricción del movimiento en la parte superior del mismo. La radiografía de tórax mostró una masa en la parte superior del pulmón izquierdo, por lo que la paciente fue evaluada con una tomografía computarizada que confirmó una masa significativa en la región paratraqueal izquierda, con apreciación de pequeños nódulos en ambos pulmones.

Se realizó un estudio de tomografía por emisión de positrones con fluordeoxiglucosa (FDG-PET) del cuerpo entero por sospecha de malignidad. El estudio indicó una alta acumulación de FDG en las lesiones pulmonares, y principalmente en la región paratraqueal izquierda. Los hallazgos del FDG-PET fueron altamente sospechosos de malignidad, por lo que se realizó una biopsia toracoscópica de la lesión. Los hallazgos histológicos y las pruebas histoinmunoquímicas fueron compatibles con el hemangioendotelioma epiteloide pulmonar (HEP). El hemangioendotelioma epiteliode (EH) es una denominación sistémica que representa un tipo raro de tumor maligno de origen vascular epiteloide que puede aparecer en el hueso, hígado, tejido blando o pulmón. El HEP es conocido actualmente como la forma EH en el pulmón. Por consiguiente, nuestra paciente tuvo una resección de la masa paratraqueal izquierda.

Este trabajo presenta un caso raro de HEP confirmado histológicamente, el cual muestra una acumulación incrementada de FDG en el estudio FDG-PET. El HEP debería añadirse a las otras causas de incremento de captación de FDG.

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Notas clínicasIncreased FDG uptake in pulmonary epitheloid hemangioendotheliomaCaptación aumentada de FDG en hemangioendotelioma epiteloide pulmonar

Abstract

Resumen

Chest

Hum Pathol

Semin Nucl Med

Lung Cancer

Pulmonary epitheloid hemangioendothelioma: a peculiar rare tumor of vascular origin

W V Med J

Epithelioid hemangioendothelioma of the pleura: clinical and radiologic features

AJR Am J Roentgenol

Multicentric epithelioidal hemangioendothelioma of bone: diagnostic imaging

Clin Nucl Med

Scintigraphic imaging of hepatic epithelioid hemangioendothelioma

Digestion

Intravascular bronchoalveolar tumor

Am J Pathol

Notas clínicas
Increased FDG uptake in pulmonary epitheloid hemangioendotheliomaCaptación aumentada de FDG en hemangioendotelioma epiteloide pulmonar