title: Role of FDG-PET scan in staging of pulmonary epithelioid hemangioendothelioma.
abstract: In this report we describe a case of pulmonary epithelioid hemangioendothelioma (PEH) in a young woman. The neoplasm manifested with dry cough, chest pain, finger clubbing, and multiple bilateral pulmonary nodules on chest x-ray and computed tomographic (CT) scan. She underwent thoracoscopy, and the histological features of the lung biopsies were initially interpreted as consistent with a not-well-defined interstitial lung disease. Our patient was clinically and radiologically stable over a period of four years, after which the disease progressed to involve not only the lung but also mediastinal lymph nodes, liver and bone. Fiberoptic bronchoscopy showed subtotal occlusion of the right middle and lower lobe bronchi. The histologic examination of bronchial biopsies revealed a poorly differentiated neoplasm immunohistochemically positive for vimentin and vascular markers CD31, CD34 and Factor VIII. A diagnosis of malignant hemangioendothelioma was made. Positron emission tomography (PET) is more sensitive than CT scan and bone scintigraphy in detecting PEH metastases. Furthermore, 18-fluorodeoxyglucose (FDG) uptake seems to be related to the grade of malignancy of PEH lesions. Therefore, we suggest that FDG-PET should be included in the staging system and follow-up of PEH.
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Naples, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Calabrese
authors.affiliation: Department of Cardio-Thoracic and Respiratory Sciences, Second University of Naples, Naples, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Gilli
authors.affiliation: AORN Ospedale dei Colli, Division of Pulmonary Oncology, Naples, Italy.
authors.forename: Nicolina
authors.initials: N
authors.lastname: De Rosa
authors.affiliation: AORN Ospedale dei Colli, Division of Pathology, Naples, Italy; Department of Medicine and Surgery, Section of Respiratory Disease, University of Salerno, Salerno, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Di Crescenzo
authors.affiliation: AORN Ospedale dei Colli, Division of Pathology, Naples, Italy; Department of Medicine and Surgery, Section of Respiratory Disease, University of Salerno, Salerno, Italy.
authors.forename: Pio
authors.initials: P
authors.lastname: Zeppa
authors.affiliation: AORN Ospedale dei Colli, Division of Pathology, Naples, Italy; Department of Medicine and Surgery, Section of Respiratory Disease, University of Salerno, Salerno, Italy.
authors.forename: Carolina
authors.initials: C
authors.lastname: Vitale
authors.affiliation: University of Salerno, Department of Medicine and Surgery, Baronissi Campus, Via S. Allende, Baronissi (SA), Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Vatrella
keywords: CT-scan; FDG-PET; lung cancer staging; pulmonary epithelioid hemangioendothelioma