Diagnosis and treatment of primary pulmonary synovial sarcoma: one case report and literature review

Abstract

Objective To evaluate the clinical manifestations, imaging characteristics, pathology and immunochemistry of primary pulmonary synovial sarcoma and to improve the understanding of the disease. Methods A retrospective study was performed in 18 cases of primary synovial sarcoma combining with one patient with primary synovial sarcoma who was diagnosed recently in Weifang People's Hospital, the clinical manifestations, imaging characteristics, pathological features and immunohistochemical characteristics were analyzed. Results Clinical manifestations included cough, expectoration, chest pain, and chest tightness.Chest X-ray and CT scan showed a heterogenous mass in lung with clear margin or lobular shape.Contrast enhanced CT showed heterogeneous enhancement of the mass, intumescent mediastinal lymph node and pleural effusion were seen.Pathological examination showed spindle cell carcinoma with common mitotic count.Immunohistochemistry revealed that EMA, Bcl-2 and Vimentin were positive. Conclusions Primary synovial sarcoma of the lung has no characteristic clinical and imaging manifestations and is difficult to be differentiated from other sarcoma of lung.The diagnosis depends on pathological and immunohistochemistry examination. Key words: Primary synovial sarcoma of lung; Pathology; Immunohistochemistry