Synovial sarcoma of the lung presenting late with compression of mediastinal structures and its successful resection: A case report

Fatimi, Saulat Hasnain; Anees, Amna; Hanif, Hashim Muhammad; Muzaffar, Marium

doi:10.1016/j.hlc.2010.07.006

Cited by 2 publications

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References 15 publications

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“…Synovial sarcoma (SS) is one of the common soft tissue sarcomas occurring predominantly in the extremities around the large joints of adolescents and young adults . Although the majority of SS arise in the lower extremity, a significant number arise from other anatomic sites such as abdominal wall, head and neck, retroperitoneum, lung, and mediastinum . The cytomorphology of fine needle aspiration (FNA) biopsies from primary SS of various anatomic sites has been previously described .…”

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Fine needle aspiration of primary mediastinal synovial sarcoma: Cytomorphologic, immunohistochemical, and molecular study

Huang

Michael

Pang

2012

Diagnostic Cytopathology

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The cytologic diagnosis of synovial sarcoma (SS) can be difficult when it occurs in unusual locations, atypical age groups, and/or have unusual morphology. We report a case of primary mediastinal SS in a 65-year-old male with a long smoking history who presented with increasing shortness of breath and was found to have a 14.2 cm mediastinal mass. Smears from the endobronchial ultrasound guided fine needle aspiration of the mass were moderately cellular consisting of loosely cohesive clusters, some of which demonstrated nuclear molding, and dispersed single cells. The relatively uniform tumor cells had a high nuclear-to-cytoplasmic ratio, finely granular chromatin, and inconspicuous nucleoli. Some of the single cells had spindled morphology with unipolar wispy tails and naked nuclei. Based on the clinical presentation and the cytomorphologic features, our initial differential diagnoses included atypical carcinoid, small cell carcinoma, basaloid squamous cell carcinoma, sarcoma, and lymphoma. Immunohistochemical studies on the cell block sections revealed that the tumor cells were focally positive for cytokeratin and diffusely positive for CD56, while negative for CD45, synaptophysin and chromogranin. Ultimately, an immunohistochemical stain for TLE-1 demonstrated diffusely strong nuclear positivity and molecular studies showed the presence of the t(X; 18) SYT/SSX1 translocation confirming the diagnosis of SS. In this report, we describe the cytomorphologic features of SS, its diagnostic pitfalls, and potential mimics in the mediastinum.

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confidence: 99%