Surgical removal is generally curative, but about 1/5 of the patients develop metastases. These tumors occur in almost all locations. Vascular lumina are evident, and there is a paucity of mitoses. The epithelioid variant displays endothelial cells with considerable eosinophilic, often vacuolated, cytoplasm. Reflex Testing Policy: Reflex testing may be performed in the absence of a specific. Discussion: Hemangioendothelioma is a vascular tumor of endothelial cells that is intermediate between benign hemangiomas and frankly malignant angiosarcomas. Microscopically, the tumor was composed of endothelial cells having abundant, eosinophilic, vacuolated cytoplasm and intracellular vascular lumina Immunohistochemical studies performed on formalin-fixed, paraffin-embedded tissue revealed that the neoplastic endothelial cells expressed CD31, CD34, and thrombomodulin, but were negative for low and high molecular weight cytokeratins (AE1/AE3) and human herpesvirus-8. On cut surface, a well circumscribed 9.0 × 9.0 × 8.0 cm lobulated brown lesion was seen in the lateral spleen occupying greater than half of the organ. Pathologic Findings On gross examination, the 510 g spleen measured 17.5 × 10.0 × 7.0 cm and displayed a smooth, dark pink surface with an intact capsule.
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