Home   Chapter Home   Jobs   Conferences   Fellowships   Books

Advertisement

Lung tumor

Other malignancies

Synovial sarcoma

Reviewer: Deepali Jain, M.D. (see Reviewers page)
Revised: 22 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
=========================================================================

● Rare tumor in lung
● Associated with chest pain, hemoptysis, dyspnea, cough, fever
● Rarely is cystic (Am J Surg Pathol 2010;34:1176)
● 40-55% die of disease after 20 years follow-up, due to metastases to bone, CNS, liver, or invasion of adjacent organs
● Tumors with SYT-SSX2 fusion proteins have 89% 5 year survival vs. 42% for tumors with SYT-SSX1 fusion protein

Case reports
=========================================================================

● 45 year old woman with SYT-SSX2 and rapidly progressive course (Arch Pathol Lab Med 2003;127:e201)
● 72 year old white man with poorly differentiated tumor with rhabdoid features (Arch Pathol Lab Med 2003;127:e160)

Micro description
=========================================================================

● Monophasic spindle cells or biphasic with epithelial and spindle cell component
● Monophasic tumors have compact fascicles of hyperchromatic spindle cells with hemangiopericytoma-like areas, often punctuated by small arteries and capillaries in an irregular distribution
● Poorly differentiated tumors have small, round blue cells resembling Ewing sarcoma/PNET
● Rarely rhabdoid features

Micro images
=========================================================================

H&E, BCL2, CD99, CD117


Poorly differentiated tumor: H&E and vimentin

Positive stains
=========================================================================

● TLE1 highly specific (Virchows Arch 2011;459:615)

Negative stains
=========================================================================

● CD117 (most cases)

Molecular description
=========================================================================

● t(X;18)(p11.2;icq11.2)
● Produces either SYT-SSX1 or SYT-SSX2 fusion genes

Differential diagnosis
=========================================================================

● Monophasic tumor resembles fibrosarcoma
● Carcinosarcoma: may be primary or metastatic
● Hemangiopericytoma
● Leiomyosarcoma
● Spindle cell carcinoma

End of Lung tumor > Other malignancies > Synovial sarcoma

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).