Pathological features of hepatic epithelioid hemangioendothelioma: An analysis of 5 cases

Objective To investigate the clinicopathological features of hepatic epithelioid hemangioendothelioma ( HEHE) . Methods The clinical data, histopathological data, and immunohistochemical results of 5 patients with HEHE were observed. Results There were 3 male and 2 female patients. Major clinical manifestations included persistent abdominal discomfort, abdominal pain, nausea, loss of weight, and pyrexia. One patient was found to have this disease during physical examination. Of all patients, 2 had a single nodule and 3 had multiple nodules. The tumor cells were relatively normal in morphology and were arranged in a cord-like shape or a small nested shape; the cells had a round, spindle-like, or irregular shape; the cells were rich in epithelioid eosinophilic cytoplasm, with branched cytoplasmic processes and cavity formation in cytoplasm. The tumor background was characteristic mucoid hyaline degeneration of cartilage-like matrix or glassy degeneration of fibrous matrix. Nuclear division and necrosis were observed occasionally. Vascular markers, such as CD31, CD34, Fli-1, coagulation factor VIII, and vascular endothelial growth factor, were expressed in tumor cells, and tumor cells tended to have a low proliferative activity. Conclusion HEHE has various clinical manifestations and treatment methods. Liver biopsy helps to make a confirmed diagnosis and select a proper treatment regimen before treatment.