PMC8060744_01
Coronal and transverse CT with contrast images of lung demonstrating subsegmental right
lower lobe atelectasis with volume loss in the right hemithorax and asymmetric right
greater than left diffuse interlobular septal thickening. Asymmetric lymphangitic
carcinomatosis could present with a similar appearance.
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A chest CT angiogram with PE protocol showed a segmental PE associated with atelectasis, right diaphragm paralysis, and worsening interstitial-nodular opacities (Figure 1).
High-grade epithelioid hemangioendothelioma forming a 17.7 cm mass involving the
humerus bone and adjacent soft tissue: (a) sheets of neoplastic cells in a fibrotic and
desmoplastic background. (b and c) The neoplastic cells are of epithelioid cytology with
many containing cytoplasmic vacuoles (arrows) which occasionally contain erythrocytes
(arrow c). (d) The neoplastic cells are characteristically positive for CAMTA1. (e and
f) Highgrade epithelioid hemangioendothelioma metastatic to lung (autopsy). (e)
Lymphangitic distribution of tumor cells including subpleural (arrow heads) and
interlobular septal (arrow) tumor spread. (f) The tumor cells are in interlobular septa
(left hand side) and within lymphangitic spaces (right hand side). Magnification x40
(a), x400 (b, c-cropped, d, f), x12.5 (e).
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Autopsy revealed acute bronchopneumonia superimposed on organizing fibrinous pneumonia, right pulmonary artery thromboembolism, and EHE in a lymphangitic and intraparenchymal distribution (Figure 2).