Progressive growth of primary synovial sarcoma of the lung

• Published in: Annals of thoracic and cardiovascular surgery Vol. 16; no. 3; pp. 194 - 197
• Main Authors: Nakano, Jun, Yokomise, Hiroyasu, Huang, Cheng-Long, Misaki, Noriyuki, Chang, Sung-Soo, Okuda, Masaya, Kushida, Yoshio, Haba, Reiji
• Format: Journal Article
• Language: English
• Published: Japan 01.06.2010
• Subjects: Aged, 80 and over; Disease Progression; Humans; Lung Neoplasms - pathology; Lung Neoplasms - surgery; Lymph Node Excision; Male; Pneumonectomy; Sarcoma, Synovial - pathology; Sarcoma, Synovial - surgery
• ISSN: 2186-1005

An 80-year-old male was admitted because of a giant mass in the left lower lobe of the lung on a routine chest X-ray. Chest computed tomography verified this to be a well-defined heterogeneous mass as described with no associated lymphadenopathy. FDG-PET depicted moderately marginal FDG uptake. The patient underwent a left lower lobectomy and lymphadenectomy. Grossly, the tumor measured 60 × 50 mm and was uniformly filled with a pure white, pudding-like friable substance. No lymph node metastasis was observed microscopically. Histologically, the tumor showed a dense proliferation of rounded or spindled malignant cells with a frequent mitotic activity and an increased nuclear-to-cytoplasmic ratio. The immunohistochemical staining was positive for vimentin, negative for cytokeratin, keratin-wide, EMA, CD34. A SYT-SSX2 fusion gene transcript was detected as a result of RT-PCR analysis. Because of these results, the tumor was diagnosed as a monophasic synovial sarcoma.