Pulmonary Epithelioid Hemangioendothelioma: Imaging and Clinical Features

J Comput Assist Tomogr. 2021 Sep-Oct;45(5):788-794. doi: 10.1097/RCT.0000000000001194.


Objective: The aim of this study was to analyze the computed tomography (CT), fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), and clinical findings of pulmonary epithelioid hemangioendothelioma.

Methods: Eighteen patients were included. We reviewed CT and PET/CT features and clinical information. Spearman correlation analysis was used to reveal the correlation between lesion size and maximum standardized uptake values (SUVmax).

Results: Eleven patients complained of different symptoms. The serum levels of tumor markers were elevated in 8 patients (44.4%). Multiple lesions were shown in 14 cases (77.8%). Eleven cases (61.1%) presented as bilateral multiple perivascular lesions. The size of the largest nodule was less than 20 mm in diameter in 11 cases (61.1%). Eleven cases underwent PET/CT examination, and 8 cases (72.7%) had increased FDG uptake. There was a positive correlation (Spearman correlation coefficient, 0.56; P = 0.009) between lesion size and SUVmax. Extrapulmonary involvement was shown in 7 cases, including the liver and bone.

Conclusions: Pulmonary epithelioid hemangioendothelioma on CT scan usually showed multiple bilateral perivascular lung nodules, generally measuring less than 20 mm in diameter. Lesions usually showed increased FDG uptake on PET/CT scans. There was a positive correlation between lesion size and SUVmax. The liver and bone were the most frequently involved extrapulmonary organs.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Fluorodeoxyglucose F18*
  • Hemangioendothelioma, Epithelioid / diagnostic imaging*
  • Humans
  • Lung / diagnostic imaging
  • Lung Neoplasms / diagnostic imaging*
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography / methods*
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*
  • Young Adult


  • Fluorodeoxyglucose F18