Lollipop sign (hepatic epithelioid hemangioendothelioma)

Last revised by Ayla Al Kabbani on 18 May 2022

Citation, DOI, disclosures and article data

Citation:

Sarangi P, Al Kabbani A, Bell D, et al. Lollipop sign (hepatic epithelioid hemangioendothelioma). Reference article, Radiopaedia.org (Accessed on 16 Apr 2024) https://doi.org/10.53347/rID-65105

DOI:

https://doi.org/10.53347/rID-65105

Permalink:

https://radiopaedia.org/articles/65105

rID:

65105

Article created:

23 Dec 2018, Pradosh Kumar Sarangi

Disclosures:

At the time the article was created Pradosh Kumar Sarangi had no recorded disclosures.

View Pradosh Kumar Sarangi's current disclosures

Last revised:

18 May 2022, Ayla Al Kabbani ◉

Disclosures:

At the time the article was last revised Ayla Al Kabbani had no recorded disclosures.

View Ayla Al Kabbani's current disclosures

Revisions:

5 times, by 4 contributors - see full revision history and disclosures

Systems:

Hepatobiliary, Oncology

Sections:

Signs

Synonyms:

Lollipop sign (HEHE)

The lollipop sign is seen in hepatic epithelioid hemangioendothelioma (HEHE). It represents hepatic/portal vein and/or their tributaries/branches tapering and terminating at or just within the edge of a well defined peripherally enhancing (or non-enhancing) lesion with an avascular core on CT or MRI. This sign is a combination of two structures: the hypodense/hypointense well-defined tumor mass on enhanced CT/MRI (the candy in the lollipop or target appearance) and the histologically occluded vein (the stick). This sign may improve the recognition of HEHE on cross-sectional imaging ^1,2.

The target-like MR imaging appearance of HEHE tumors may be due to a central zone of fibrosis and a rim of cellular proliferation, with central signal hypointensity corresponding to hemorrhage, necrosis, or both, and peripheral hyperintensity corresponding to tumor cellularity and adjacent edema ².