Primary Pulmonary Synovial Sarcoma: Case Report with Unusual Histology and Diagnostic Pearls

Paul H. Hartel

Department of Histopathology, Sligo University Hospital, Ireland

^*Correspondance to: Paul Hartel 

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Abstract:

Primary pulmonary synovial sarcoma is rare and poses a diagnostic challenge when unusual histologic features are present and t(x; 18) is negative. We present a case of a 49 year old female with left lung mass and left pleural nodule showing typical clinical and radiologic features of pulmonary synovial sarcoma with focal unusual histomorphology. While dense cellularity, interlacing fascicles, and hyalinized stroma were seen, this tumour showed unusual histologic features not usually seen with pulmonary synovial sarcoma but typical of other neoplasms, in particular, Verocay bodies, rhabdoid morphology, and vague rosette formation. Immunohistochemistry demonstrated PanCytokeratin and CK7 immunoreactivity with focal S-100 expression, but were negative for muscle markers, other melanoma markers, and CD34. The tumour was negative for t(x; 18). In conclusion, awareness of focal unusual histology in otherwise typical pulmonary synovial sarcoma can prevent misdiagnosis, particularly when t(x; 18) is negative.

Keywords:

Pulmonary; Pleura; Synovial sarcoma

Cite the Article:

Hartel PH. Primary Pulmonary Synovial Sarcoma: Case Report with Unusual Histology and Diagnostic Pearls. Clin Case Rep Int. 2018; 2: 1037.