Synovial sarcoma of the pleura and its differentiation from other primary pleural tumours: a clinicopathological and immunohistochemical review of three cases

Ag, Nicholson; Goldstraw, Peter; Fisher, Cyril

doi:10.1046/j.1365-2559.1998.00565.x

Cited by 99 publications

(76 citation statements)

References 27 publications

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“…Our radiologic images, documented in a recent review, 12 support the diagnosis of primary pulmonary and mediastinal synovial sarcoma. On chest radiographs, the lesion is typically uniform with well-circumscribed rounded or lobu- lated borders [13][14][15] with mediastinal shift in some patients. 16 Computed tomography demonstrates a well-defined homogeneous or heterogeneously enhancing mass containing necrotic areas and soft tissue components (Figure 1).…”

Section: Discussionmentioning

confidence: 99%

“…16 Computed tomography demonstrates a well-defined homogeneous or heterogeneously enhancing mass containing necrotic areas and soft tissue components (Figure 1). Ipsilateral pleural effusion is common, 5,[13][14][15][16] while mediastinal lym-phadenopathy is rare. 13 Sarcomas arising in the chest wall closely match the imaging characteristics of soft tissue synovial sarcoma with cortical bone destruction, tumor calcification and/or invasion into chest wall musculature, 17,18 features not observed on imaging in our study.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…13,26 Chilosi 4 found that synovial sarcoma was Bcl-2 positive. Analogously, Nicholson 18 and Suster 25 found Bcl-2 positivity in 100% of synovial sarcomas. Segers 23 and Nakanishi 17 found that synovial sarcoma could be also Bcl-2 negative.…”

Section: Discussionmentioning

confidence: 85%

Poorly differentiated synovial sarcoma: A case report

Cappello

Bellafiore

Bucchieri

et al. 2001

Pathol. Oncol. Res.

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“…However, there is growing evidence that synovial sarcoma may develop as a primary tumour in the pleura. [15][16][17][18][19][20] In this regard during the last five years (2001)(2002)(2003)(2004)(2005), 3209 malignant mesotheliomas were certified by the French Mesothelioma panel (Mesopath group), 353 were sarcomatoid mesotheliomas (11%). Among sarcomatoid mesotheliomas, 54 were poorly differentiated, pleomorphic tumours (1.7% of all malignant mesotheliomas, 14% of sarcomatoid mesotheliomas).…”

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confidence: 99%

SYT-SSX fusion is absent in sarcomatoid mesothelioma allowing its distinction from synovial sarcoma of the pleura

et al. 2007

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The diagnosis of sarcomatoid mesothelioma is still a worldwide challenge and it is often difficult, both clinically and by morphological analysis, to differentiate sarcomatoid mesothelioma from synovial sarcoma, the most frequent intrathoracic sarcoma. To confirm the absence of the synovial sarcoma translocation t(X; 18) (SYT-SSX) in sarcomatoid mesothelioma, and to test its usefulness differentiating sarcomatoid mesothelioma from synovial sarcoma, 28 tumours were examined using the reverse transcriptase-polymerase chain reaction. RNA was extracted from paraffin blocks using standard methods, reverse-transcribed and PCR performed. Molecular analysis completed in two independent laboratories showed that sarcomatoid mesothelioma samples were negative for the t(X-18). This result confirms the usefulness of this analysis in differentiating sarcomatoid mesothelioma from synovial sarcoma.

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Synovial sarcoma of the pleura and its differentiation from other primary pleural tumours: a clinicopathological and immunohistochemical review of three cases

Cited by 99 publications

References 27 publications

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

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

Poorly differentiated synovial sarcoma: A case report

SYT-SSX fusion is absent in sarcomatoid mesothelioma allowing its distinction from synovial sarcoma of the pleura

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