PMC6039087_01
Abdominal MRI performed at 1, 9, 16 months.. (A) MRI at the diagnosis. Solid tissue hypointense on T2-weighted images with post-contrast enhancement extended in the retroperitoneal area surrounding all upper abdominal vessels, adrenal glands and the left renal hilum (61x12 mm, black arrows). Lesions with the same characteristics also interest the hepatic hilum (36x12mm, white arrow) and the mesenteric adipose tissue. Left kidney enlarged with pyelectasis. Pancreas enlarged with areas showing post-contrast enhancement at the body-tail level. Progressive reduction in mass size after 1 month (B), 9 months (C) and 19 months (D).
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The lesion was confirmed by magnetic resonance imaging (MRI) (Figure 1). The MRI performed at 1, 9, 16 months showed a progressive reduction of the mass (Figure 1).
Biopsy histological features.. Hematoxylin Eosin 400X magnification. Proliferation of neoplastic spindle cells, sparsely forming capillaries with red blood cells inside.
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A biopsy was performed: the histological features (Figure 2) and the immunophenotype with CD 31 (JC/70A) +, CD 34 (QBEND/10)+, GLUT1 -/+, PODOPLANIN (D2-40) +, PROTEIN S100 -, Herpes virus 8 (13B10) - were diagnostic for KHE and the clinical and laboratory features were indicative of KMS.