MRI of Hepatic Epithelioid Hemangioendothelioma (HEH)

Since the publication of the seminal work on the histology-based classification of vascular anomalies by Mulliken and Glowacki in 1982 and the subsequent adoption of an expanded and modified version in 1996 by the International Society for the Study of Vascular Anomalies, an increasing number of vascular lesions have been recognized as histologically distinct entities. Furthermore, there have been significant advances in detailing the behavior and underlying genetics of previously identified lesions. These developments have required restructuring and expansion of the classification scheme so that appropriate therapies may be studied and implemented in affected patients. The new classification retains the broad categories of neoplasms and malformations but now divides the tumor group into benign, locally aggressive or borderline, and malignant, with the malformation group being divided into simple, combined, those of major named vessels, and those associated with other anomalies. Additionally, a category has been created for lesions in which the histology and behavior do not yet allow clear separation into neoplasm or malformation (thus named "provisionally unclassified vascular anomalies"). The known clinical courses and imaging, histologic, and genetic findings of the most common and/or clinically relevant lesions in the newly adopted revised system are reviewed in this article. (©)RSNA, 2016.

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“…Additionally, the lesion frequently causes capsular retraction of the liver (Fig 13). Calcifications are found in 20% of cases (32)(33)(34)(35).…”

Section: Malignant Neoplasmsmentioning

confidence: 99%

2014 Revised Classification of Vascular Lesions from the International Society for the Study of Vascular Anomalies: Radiologic-Pathologic Update

Merrow

Gupta

Patel³

et al. 2016

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“…Çoğu vaka asemptomatik aşamada saptansa da, yaygın hastalığı olan vakalarda diffüz tümör infiltrasyonuna bağlı karaciğer yetmezliği gözlenebilir [22][23][24][25].…”

Section: Epiteloid Hemanjioendotelyomaunclassified

“…Neoplastik endotel hücreleri sinüzoidleri, portal ve hepatik ven dallarını tıkayabilir. Bu intravasküler büyüme paterni tümörün kendi damarlarını tıkayarak "intihar" iskemisiyle sonuçlanabilir [22][23][24][25].…”

Section: Epiteloid Hemanjioendotelyomaunclassified

“…US incelemede EH tümör ekojenitesi değişkenlik gösterse de çoğunlukla birbirinden ayrık multiple hipoekoik nodüller şeklinde gözlenir [23,24]. BT incelemede karaciğerin her iki lobunu da tutan hipodens kitleler şek-linde gözlenirler ve bu kitlelere periferal ya da subkapsüler bölgede birleşerek daha büyük [22][23][24][25].…”

Section: Epiteloid Hemanjioendotelyomaunclassified

“…BT incelemede karaciğerin her iki lobunu da tutan hipodens kitleler şek-linde gözlenirler ve bu kitlelere periferal ya da subkapsüler bölgede birleşerek daha büyük [22][23][24][25]. EH MRG incelemede T1A görüntülerde düşük, T2A görüntülerde yüksek sinyal özelliğindedir.…”

Section: Epiteloid Hemanjioendotelyomaunclassified

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