title: Pulmonary epithelioid hemangioendothelioma: report of a case with fine needle aspiration biopsy.
abstract: BACKGROUND
  Pulmonary epithelioid hemangioendothelioma (PEH) is a rare, low grade, malignant vascular tumor that typically presents with multiple pulmonary nodules in young women. This report details the cytopathologic and pathologic findings in an unusual case presenting in an older male with a pleural effusion, dominant nodule and multiple bilateral infiltrates.
  
  
  METHODS
  A 62-year-old, male nonsmoker was referred due to increasing dyspnea. Chest radiography revealed a pleural effusion and nodular infiltrate in the right upper lobe of the bronchus. Thoracocentesis and thoracoscopy were performed, with a pleural drain inserted. Bronchoscopy revealed a right upper lobe bronchus occluded by a greyish, necrotic mass. Various cytopathologic sampling techniques, including fine needle aspiration biopsy, as well as traditional histopathologic biopsies were performed. Cytologic specimens showed loosely cohesive, epithelioid cells that were binucleated and multinucleated. Chromatin was granular, with scattered, small, multiple nucleoli with occasional, variably sized cytoplasmic vacuoles. The patient's condition deteriorated, and he died 3 weeks after admission.
  
  
  CONCLUSIONS
  Pulmonary epithelioid hemangioendotheliomas are unusual neoplasms with a epithelioid, discohesive cellular appearance. It can mimic other, more commonly seen pulmonary neoplasms. Careful attention to cytomorphologic features and application of ancillary studies assist in making the diagnosis.
authors.affiliation: Department of Clinical Cytology, Karolinska Hospital, Stockholm, Sweden.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carretero
authors.forename: P Göran
authors.initials: PG
authors.lastname: Elmberger
authors.forename: C Magnus
authors.initials: CM
authors.lastname: Sköld
authors.forename: Brian T
authors.initials: BT
authors.lastname: Collins
mesh_terms: D044963:Biopsy, Fine-Needle; D001808:Blood Vessels / Q000473:pathology; D018323:Hemangioendothelioma, Epithelioid / Q000473:pathology*; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000276:immunology; D035422:Pleural Cavity / Q000473:pathology
chemical_list: D019408:Platelet Endothelial Cell Adhesion Molecule-1