Objective To investigate the clinicopathological characteristics,differential diagnosis and prognosis of hepatic epithelioid hemangioendothelioma(EH).Methods The morphological characteristics of 4 cases of hepatic EH were observed.The immunohistochemical approach and literature review were employed.Results The tumor cells were epithelioid,spindle or polygonalshaped and exhibited cord-like,small nests or intravascular papillary growth pattern.Some tumor cells formed empty cytoplasmic vacuoles,of which contained red blood cell fragments.The tumor cells showed rare mitotic figures,abundant eosinophilic cytoplasm and unclear cell-cell boundaries with mesenchymal mucus or hyaline appearance.The tumor cells were positive for CD31,CD34 and Vim.Conclusion Hepatic EH is a rare,low-grade,malignant neoplasm of vascular origin that may be easily misdiagnosed by imaging.Pathological morphology and immunohistochemistry are needed to facilitate the identification and diagnosis.%目的 探讨肝上皮样血管内皮瘤(EH)的临床病理特点、鉴别诊断及预后.方法 观察4例肝EH的组织形态学特点并行免疫组化检测,并结合相关文献进行分析.结果 EH镜下肿瘤细胞为上皮样、梭形或多角形,呈条索状、小巢状生长,或在血管内呈乳头状生长,部分瘤细胞胞质空泡化,内含红细胞；核分裂像罕见,瘤细胞胞质丰富,嗜酸性,胞界不清,间质黏液样变或玻璃样变.免疫组化染色显示肿瘤细胞CD31、CD34、Vim阳性.结论 肝EH是一种少见的低度恶性的血管源性肿瘤,影像学易误诊,需依靠病理形态学及免疫组化确诊.
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