PMC8525909_01
CT of a 49-year-old female patient with mediastinal epithelioid haemangioendothelioma (EHE) at the first treatment. (A) An unenhanced CT revealed a mass in the left anterior mediastinum, and the interface between the lung and the mass was smooth (arrow). (B) Spotted calcification (long arrow) and fatty foci (short arrow) were observed inside the mass, and the lesion was closely connected with mediastinal vessels and the anterior chest wall. (C) An enhanced CT of the venous phase indicated a mass with asymmetrical mild enhancement, and the collateral circulation of the left upper chest wall was opened abnormally (arrow).
fsurg-08-678572-g0001.jpg
PMC8525909_01_fsurg-08-678572-g0001.jpg
F1
Enlarged lymph nodes of the mediastinum or evident abnormal density shadows of the thymus area could not be observed, and other sites, including the thoracic vertebrae, showed no obvious abnormalities (Figures 1A-C).
Pathology of a 49-year-old female patient with mediastinal EHE at the first treatment. (A) Histology showed that the tumour was composed of epithelioid cells and fusiform cells (HE, x 200). (B) Small focal necrosis and tumour thrombi in the vessels and nuclear division were observed (HE, x 400). (C-E) Immunohistochemistry showing tumour cells positive for CD34 (C), CD31 (D), and vimentin (E), scale bar = 200 mum.
fsurg-08-678572-g0002.jpg
PMC8525909_01_fsurg-08-678572-g0002.jpg
F2
Nuclear division was observed, with an average of less than 1/10 high power field (HPF) (Figures 2A,B). The immunohistochemical results were as follows: vimentin (++) (Figure 2C); CD34 (++) (Figure 2D); CD31 (++) (Figure 2E); F8 (+); cytokeratin (AE1/AE3) (CK (AE1/AE3)) (-); epithelioma antigen (EMA) (-); smooth muscle actin (SMA) spindle cells (+); desmin (-); calretinin (-); CD5 (-); and S-100 (focal+).
CT and MRI of a 49-year-old female patient with mediastinal EHE before the second treatment. (A-D) CT (A,B), and MRI (C,D) revealed multifocal lesions of the thoracic vertebrae 5-7. (E) An enhanced MRI of the venous phase revealed multifocal lesions of the thoracic vertebrae with obvious asymmetrical enhancement. (F) The CT indicated a local ruin of the left transverse process of the 10th thoracic vertebra (arrow).
fsurg-08-678572-g0003.jpg
PMC8525909_01_fsurg-08-678572-g0003.jpg
F3
T10 vertebra (Figure 3F).
CT of a 49-year-old female patient with mediastinal epithelioid haemangioendothelioma (EHE) at the latest review. (A) CT revealed that the lesion of the left transverse process of the T10 vertebra was small and localised (arrow). (B) A CT image of a sagittal reconstruction showed that the internal fixations of thoracic vertebrae were stable.
fsurg-08-678572-g0004.jpg
PMC8525909_01_fsurg-08-678572-g0004.jpg
F4
The CT showed that the lesion of the left transverse process of the T10 vertebra remained stable (Figures 4A,B), and there was no recurrence or other metastasis.
The schedule of diagnosis and treatment of a 49-year-old female patient with mediastinal EHE.
fsurg-08-678572-g0005.jpg
PMC8525909_01_fsurg-08-678572-g0005.jpg
F5
The schedule of diagnosis and treatment is shown in Figure 5 below.