Primary pulmonary synovial sarcoma: a clinicopathologic, immunohistochemical, and molecular study of 11 cases

Okamoto, Sumika; Hisaoka, Masanori; Daa, Tsutomu; Hatakeyama, Kinta; Iwamasa, Teruo; Hashimoto, Hiroshi

doi:10.1016/j.humpath.2004.02.011

Cited by 92 publications

(75 citation statements)

References 49 publications

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“…2,3 Primary pulmonary and mediastinal synovial sarcoma is an aggressive tumor sharing common histological features with soft tissue synovial sarcoma. [3][4][5][6][7] Molecular testing for the pathognomonic t(x;18) chromosomal translocation has enabled diagnostic confirmation in approximately 90% of cases. 8 In t(x;18)-negative cases, diagnosis must rely on histological and immunophenotypic features.…”

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confidence: 99%

Primary pulmonary and mediastinal synovial sarcoma: a clinicopathologic study of 60 cases and comparison with five prior series

et al. 2007

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Primary pulmonary and mediastinal synovial sarcoma is rare and poses a diagnostic challenge particularly when unusual histological features are present. We present 60 cases of primary pulmonary and mediastinal synovial sarcoma (29 male and 27 female subjects; mean age, 42 years) and compare our results with five prior series to better define unusual histological features. Clinically, patients with mediastinal synovial sarcoma were younger with a male gender bias. Radiologically, tumors were well delineated with distinctive magnetic resonance imaging features and little vascular enhancement. In all, 21/46 patients died of disease within 5 years. Histologically, all tumors had dense cellularity, interlacing fascicles, hyalinized stroma, and mast cell influx. Hemangiopericytoma-like vasculature (48/60), focal myxoid change (30/60), and entrapped pneumocytes (23/60) were seen. Calcification was not prevalent (10/60). Unusual histological features included Verocay body-like formations (7/60), vague rosettes (6/60), well-formed papillary structures (3/60), adenomatoid change (3/60), and rhabdoid morphology (2/60). Immunohistochemistry demonstrated expression of pancytokeratin (39/58), epithelial membrane antigen (29/53), cytokeratin 7 (26/40), cytokeratin 5/6 (5/7), calretinin (15/23), CD99 (19/ 23), bcl-2 (24/24), CD56 (11/11), S-100 (9/51), and smooth muscle actin (8/32). In total, 92% (36/39) of primary pulmonary and mediastinal synovial sarcomas studied were positive for t(x;18). In conclusion, our study confirms the clinical, histological, immunohistochemical, and molecular data from previous large series of primary pulmonary and mediastinal synovial sarcoma. Compared with soft tissue synovial sarcoma, primary pulmonary and mediastinal synovial sarcoma has less calcification, less obvious mast cell influx, and less radiologic vascularity, but similar magnetic resonance imaging features, percentage of poorly differentiated tumors, and number of t(x;18)-positive tumors. Awareness of focal unusual histology can prevent misdiagnosis particularly in t(x;18)-negative tumors.

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confidence: 99%

Primary pulmonary and mediastinal synovial sarcoma: a clinicopathologic study of 60 cases and comparison with five prior series

et al. 2007

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“…Synovial sarcoma appears in one of two major forms, monophasic or biphasic. The first is the most common pulmonary subtype (2) and is comprised solely of spindle cells, while the latter contains both spindle cells and epithelial cells arranged in glandular structures (6). The present case showed a predominantly fusocellular monophasic pattern of densely packed spindled cells with increased nuclear to cytoplasmic ratio.…”

Section: Dromamentioning

confidence: 52%

“…T y p i c a l a p p e a r a n c e wi t h f a s c i c l e s a n d s h e e t s o f u n i f o r m, r e l a t i v e l y s ma l l o v o i d n e o p l a s t i c c e l l s . My x o i d c h a n g e i s a l s o s e e n ( r i g h t ) ( h e ma t o x y l i n a n d e o s i n × 1 0 0 ) ( (1,2). Synovial sarcoma appears in one of two major forms, monophasic or biphasic.…”

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confidence: 99%

“…Immunohistochemically, most synovial sarcomas show immunoreactivity for cytokeratins and/or EMA (2,7). Bcl-2 and O-13 are frequently positive (8,9).…”

Section: Synovial Sarcoma Is the Third Most Common Histological Type mentioning

confidence: 99%

“…Synovial sarcoma, an aggressive neoplasm accounting for up to 14% of soft tissue sarcomas (1), was recently recognized as a primary tumor in the lung and pleura (2).…”

Section: Introductionmentioning

confidence: 99%

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