Imaging features of hepatic epithelioid hemangioendothelioma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Lu ^1,2 , LU Ya ³ , LIU Xijiao ¹ ,  WU Bing ¹

1. Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
2. Department of Radiology, West China No.4 Hospital of Sichuan University, Chengdu 610041, P. R. China;
3. Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WU Bing, Email: bingwu69@163.com

Keywords：

hepatic epithelioid hemangioendothelioma; computed tomography; magnetic resonance imaging

DOI：

10.7507/1007-9424.201801007

Video：

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Objective To evaluate the imaging features of hepatic epithelioid hemangioendothelioma (HEHE). Methods The imaging data of 15 patients with HEHE proved by surgery and pathology who reeived treatment in West China Hospital from Jul. 2012 to Aug. 2018, were retrospectively analyzed. The location, boundary, density/signal, and enhanced features of tumor were observed. Results Among 15 cases, there were 3 cases of single, 5 cases of multiple, and 6 cases of fusion. Thirteen cases were distributed under the capsular of liver, accompanied by the capsule retraction sign, 14 cases had lollipop sign, 7 cases had core pattern sign. On plain CT images, the lesions manifested as low density. On plain MR images, the lesions had hypointense on T1-weighted images and hyperintense on T2-weighted images. The enhanced scanning could be characterized by mild enhancement, rim-like enhancement at early phase, and progressive centripetal fill-in enhancement during dynamic phase imaging. Conclusions CT and MRI imagings of HEHE are different, and there are certain characteristics of capsule retraction sign, lollipop sign, and core pattern sign.

Citation： LIU Lu, LU Ya, LIU Xijiao, WU Bing. Imaging features of hepatic epithelioid hemangioendothelioma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(2): 229-234. doi: 10.7507/1007-9424.201801007 Copy

1.	Makhlouf HR, Ishak KG, Goodman ZD. Epithelioid hemangioendothelioma of the liver: a clinicopathologic study of 137 cases. Cancer, 1999, 85(3): 562-582.
2.	Earnest F4^th, Johnson CD. Case 96: hepatic epithelioid hemangioendothelioma. Radiology, 2006, 240(1): 295-298.
3.	Läuffer JM, Zimmermann A, Krähenbühl L, et al. Epithelioid hemangioendothelioma of the liver. A rare hepatic tumor. Cancer, 1996, 78(11): 2318-2327.
4.	Alomari AI. The lollipop sign: a new cross-sectional sign of hepatic epithelioid hemangioendothelioma. Eur J Radiol, 2006, 59(3): 460-464.
5.	Miller WJ, Dodd GD 3^rd, Federle MP, et al. Epithelioid hemangioendothelioma of the liver: imaging findings with pathologic correlation. AJR Am J Roentgenol, 1992, 159(1): 53-57.
6.	钱斌, 胡晓华, 陈宏伟, 等. 肝脏上皮样血管内皮瘤 CT 与 MR 特征及病理对照. 中华放射学杂志, 2012, 46(2): 172-174.
7.	Weiss SW, Enzinger FM. Epithelioid hemangioendothelioma: a vascular tumor often mistaken for a carcinoma. Cancer, 1982, 50(5): 970-981.
8.	Ishak KG, Sesterhenn IA, Goodman ZD, et al. Epithelioid hemangioendothelioma of the liver: a clinicopathologic and follow-up study of 32 cases. Hum Pathol, 1984, 15(9): 839-852.
9.	Amin S, Chung H, Jha R. Hepatic epithelioid hemangioendothelioma: MR imaging findings. Abdom Imaging, 2011, 36(4): 407-414.
10.	Azzam RI, Alshak NS, Pham HP. AIRP best cases in radiologic-pathologic correlation: hepatic epithelioid hemangioendothelioma. Radiographics, 2012, 32(3): 789-794.
11.	Mehrabi A, Kashfi A, Fonouni H, et al. Primary malignant hepatic epithelioid hemangioendothelioma: a comprehensive review of the literature with emphasis on the surgical therapy. Cancer, 2006, 107(9): 2108-2121.
12.	张树辉, 丛文铭, 吴孟超. 肝上皮样血管内皮瘤的临床病理特点(附 8 例报告及文献复习). 中华肝胆外科杂志, 2003, 9(6): 327-330.
13.	Furui S, Itai Y, Ohtomo K, et al. Hepatic epithelioid hemangioendothelioma: report of five cases. Radiology, 1989, 171(1): 63-68.
14.	Lyburn ID, Torreggiani WC, Harris AC, et al. Hepatic epithelioid hemangioendothelioma: sonographic, CT, and MR imaging appearances. AJR Am J Roentgenol, 2003, 180(5): 1359-1364.
15.	Bruegel M, Muenzel D, Waldt S, et al. Hepatic epithelioid hemangioendothelioma: findings at CT and MRI including preliminary observations at diffusion-weighted echo-planar imaging. Abdom Imaging, 2011, 36(4): 415-424.
16.	Lin J, Ji Y. CT and MRI diagnosis of hepatic epithelioid hemangioendothelioma. Hepatobiliary Pancreat Dis Int, 2010, 9(2): 154-158.
17.	宁周雨, 陈其文, 朱晓燕, 等. 肝脏上皮样血管内皮瘤的影像特点及临床诊治体会. 中国癌症杂志, 2016, 26(12): 1004-1011.
18.	刘权, 彭卫军, 王坚. 肝上皮样血管内皮瘤影像学表现及征象分析. 肿瘤影像学, 2014, 23(1): 8-13.
19.	Mermuys K, Vanhoenacker PK, Roskams T, et al. Epithelioid hemangioendothelioma of the liver: radiologic-pathologic correlation. Abdom Imaging, 2004, 29(2): 221-223.
20.	吕鹏, 林江, 周易, 等. 肝脏上皮样血管内皮瘤: 影像表现和病理基础. 中国医学计算机成像杂志, 2011, 7(5): 416-419.
21.	Lee JH, Jeong WK, Kim YK, et al. Magnetic resonance findings of hepatic epithelioid hemangioendothelioma: emphasis on hepatobiliary phase using Gd-EOB-DTPA. Abdom Radiol (NY), 2017, 42(9): 2261-2271.
22.	Kim EH, Rha SE, Lee YJ, et al. CT and MR imaging findings of hepatic epithelioid hemangioendotheliomas: emphasis on single nodular type. Abdom Imaging, 2015, 40(3): 500-509.
23.	Blachar A, Federle MP, Brancatelli G. Hepatic capsular retraction: spectrum of benign and malignant etiologies. Abdom Imaging, 2002, 27(6): 690-699.
24.	Soyer P. Capsular retraction of the liver in malignant tumor of the biliary tract MRI findings. Clin Imaging, 1994, 18(4): 255-257.
25.	Sans N, Fajadet P, Galy-Fourcade D, et al. Is capsular retraction a specific CT sign of malignant liver tumor? Eur Radiol, 1999, 9(8): 1543-1545.
26.	黄彬, 蔡权宇, 贾宁阳, 等. 肝上皮样血管内皮瘤的影像特征. 中华肝胆外科杂志, 2014, 20(1): 1-5.
27.	Economopoulos N, Kelekis NL, Argentos S, et al. Bright-dark ring sign in MR imaging of hepatic epithelioid hemangioendothelioma. J Magn Reson Imaging, 2008, 27(4): 908-912.

1. Makhlouf HR, Ishak KG, Goodman ZD. Epithelioid hemangioendothelioma of the liver: a clinicopathologic study of 137 cases. Cancer, 1999, 85(3): 562-582.
2. Earnest F4^th, Johnson CD. Case 96: hepatic epithelioid hemangioendothelioma. Radiology, 2006, 240(1): 295-298.
3. Läuffer JM, Zimmermann A, Krähenbühl L, et al. Epithelioid hemangioendothelioma of the liver. A rare hepatic tumor. Cancer, 1996, 78(11): 2318-2327.
4. Alomari AI. The lollipop sign: a new cross-sectional sign of hepatic epithelioid hemangioendothelioma. Eur J Radiol, 2006, 59(3): 460-464.
5. Miller WJ, Dodd GD 3^rd, Federle MP, et al. Epithelioid hemangioendothelioma of the liver: imaging findings with pathologic correlation. AJR Am J Roentgenol, 1992, 159(1): 53-57.
6. 钱斌, 胡晓华, 陈宏伟, 等. 肝脏上皮样血管内皮瘤 CT 与 MR 特征及病理对照. 中华放射学杂志, 2012, 46(2): 172-174.
7. Weiss SW, Enzinger FM. Epithelioid hemangioendothelioma: a vascular tumor often mistaken for a carcinoma. Cancer, 1982, 50(5): 970-981.
8. Ishak KG, Sesterhenn IA, Goodman ZD, et al. Epithelioid hemangioendothelioma of the liver: a clinicopathologic and follow-up study of 32 cases. Hum Pathol, 1984, 15(9): 839-852.
9. Amin S, Chung H, Jha R. Hepatic epithelioid hemangioendothelioma: MR imaging findings. Abdom Imaging, 2011, 36(4): 407-414.
10. Azzam RI, Alshak NS, Pham HP. AIRP best cases in radiologic-pathologic correlation: hepatic epithelioid hemangioendothelioma. Radiographics, 2012, 32(3): 789-794.
11. Mehrabi A, Kashfi A, Fonouni H, et al. Primary malignant hepatic epithelioid hemangioendothelioma: a comprehensive review of the literature with emphasis on the surgical therapy. Cancer, 2006, 107(9): 2108-2121.
12. 张树辉, 丛文铭, 吴孟超. 肝上皮样血管内皮瘤的临床病理特点(附 8 例报告及文献复习). 中华肝胆外科杂志, 2003, 9(6): 327-330.
13. Furui S, Itai Y, Ohtomo K, et al. Hepatic epithelioid hemangioendothelioma: report of five cases. Radiology, 1989, 171(1): 63-68.
14. Lyburn ID, Torreggiani WC, Harris AC, et al. Hepatic epithelioid hemangioendothelioma: sonographic, CT, and MR imaging appearances. AJR Am J Roentgenol, 2003, 180(5): 1359-1364.
15. Bruegel M, Muenzel D, Waldt S, et al. Hepatic epithelioid hemangioendothelioma: findings at CT and MRI including preliminary observations at diffusion-weighted echo-planar imaging. Abdom Imaging, 2011, 36(4): 415-424.
16. Lin J, Ji Y. CT and MRI diagnosis of hepatic epithelioid hemangioendothelioma. Hepatobiliary Pancreat Dis Int, 2010, 9(2): 154-158.
17. 宁周雨, 陈其文, 朱晓燕, 等. 肝脏上皮样血管内皮瘤的影像特点及临床诊治体会. 中国癌症杂志, 2016, 26(12): 1004-1011.
18. 刘权, 彭卫军, 王坚. 肝上皮样血管内皮瘤影像学表现及征象分析. 肿瘤影像学, 2014, 23(1): 8-13.
19. Mermuys K, Vanhoenacker PK, Roskams T, et al. Epithelioid hemangioendothelioma of the liver: radiologic-pathologic correlation. Abdom Imaging, 2004, 29(2): 221-223.
20. 吕鹏, 林江, 周易, 等. 肝脏上皮样血管内皮瘤: 影像表现和病理基础. 中国医学计算机成像杂志, 2011, 7(5): 416-419.
21. Lee JH, Jeong WK, Kim YK, et al. Magnetic resonance findings of hepatic epithelioid hemangioendothelioma: emphasis on hepatobiliary phase using Gd-EOB-DTPA. Abdom Radiol (NY), 2017, 42(9): 2261-2271.
22. Kim EH, Rha SE, Lee YJ, et al. CT and MR imaging findings of hepatic epithelioid hemangioendotheliomas: emphasis on single nodular type. Abdom Imaging, 2015, 40(3): 500-509.
23. Blachar A, Federle MP, Brancatelli G. Hepatic capsular retraction: spectrum of benign and malignant etiologies. Abdom Imaging, 2002, 27(6): 690-699.
24. Soyer P. Capsular retraction of the liver in malignant tumor of the biliary tract MRI findings. Clin Imaging, 1994, 18(4): 255-257.
25. Sans N, Fajadet P, Galy-Fourcade D, et al. Is capsular retraction a specific CT sign of malignant liver tumor? Eur Radiol, 1999, 9(8): 1543-1545.
26. 黄彬, 蔡权宇, 贾宁阳, 等. 肝上皮样血管内皮瘤的影像特征. 中华肝胆外科杂志, 2014, 20(1): 1-5.
27. Economopoulos N, Kelekis NL, Argentos S, et al. Bright-dark ring sign in MR imaging of hepatic epithelioid hemangioendothelioma. J Magn Reson Imaging, 2008, 27(4): 908-912.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Imaging features of hepatic epithelioid hemangioendothelioma

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