Abstract: Objective To investigate the clinicopathological characteristics， differential diagnosis and prognosis of hepatic epithelioid hemangioendothelioma（EH）.
MethodsThe 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 polygonalshaped 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.