ABSTRACT
Primary pulmonary synovial sarcoma is a rare pulmonary malignant tumor originated from primitive mesenchymal, which has short overall survival and poor prognosis. Related case reports are lacked at home and abroad. In recent years, the development of targeted therapy has brought remarkable benefits to cancer patients. Apatinib (Hengrui Pharmaceutical Co. Ltd, Jiangsu, People's Republic of China) is a small molecule vascular endothelial growth factor receptor 2 (VEGFR-2) inhibitor, which selectively inhibits VEGFR-2 and blocks the VEGF signal pathway, then strongly inhibiting the tumor angiogenesis. Apatinib has shown favorable therapeutic effect and acceptable toxicity on various tumors. Here we report a case of primary pulmonary synovial sarcoma with postoperative multiple metastases treated with apatinib, in order to provide a new considerable treatment. .
Subject(s)
Humans , Male , Middle Aged , Lung Neoplasms , Drug Therapy , Pathology , General Surgery , Neoplasm Metastasis , Postoperative Period , Pyridines , Therapeutic Uses , Sarcoma, Synovial , Drug Therapy , Pathology , General SurgeryABSTRACT
Objective To explore the CT characteristics of primary pulmonary synovial sarcoma (PPSS)to improve the understanding of the disease.Methods The clinical,imaging and pathological data of 5 patients with PPSS confirmed by operation and pathology was analyzed retrospectively.4 patients underwent enhanced CT scan,and 1 patient underwent plain CT scan.STY-SSX fusion genes of 3 patients were detected by reverse transcriptase-polymerase chain reaction (RT-PCR).Results All the lesions were located in the upper lobe of the lung.Most lesions showed as round-like heterogeneous solid masses with clear edge,3 lesions showed heterogeneous enhancement,and 2 lesions showed circular enhancement with obviously enhanced parenchyma.1 lesion was with calcification,3 lesions were with ipsilateral pleural effusion,and mediastinal lymph nodes metastasis was seen in 1 case.The immunohistochemical results showed that the expressions of Vim,CD56,CD99,Bcl-2 and Ki-67 were positive.Only 1 case was EMA individually positive.SYT-SSX gene was detected in 3 cases.Conclusion The imaging findings of PPSS are relatively specific,the diagnosis mainly relies on pathological, immunohistochemical examination and SYT-SSX detection.
ABSTRACT
Objective To explore the CT characteristics of primary pulmonary synovial sarcoma (PPSS)to improve the understanding of the disease.Methods The clinical,imaging and pathological data of 5 patients with PPSS confirmed by operation and pathology was analyzed retrospectively.4 patients underwent enhanced CT scan,and 1 patient underwent plain CT scan.STY-SSX fusion genes of 3 patients were detected by reverse transcriptase-polymerase chain reaction (RT-PCR).Results All the lesions were located in the upper lobe of the lung.Most lesions showed as round-like heterogeneous solid masses with clear edge,3 lesions showed heterogeneous enhancement,and 2 lesions showed circular enhancement with obviously enhanced parenchyma.1 lesion was with calcification,3 lesions were with ipsilateral pleural effusion,and mediastinal lymph nodes metastasis was seen in 1 case.The immunohistochemical results showed that the expressions of Vim,CD56,CD99,Bcl-2 and Ki-67 were positive.Only 1 case was EMA individually positive.SYT-SSX gene was detected in 3 cases.Conclusion The imaging findings of PPSS are relatively specific,the diagnosis mainly relies on pathological, immunohistochemical examination and SYT-SSX detection.
ABSTRACT
Primary sarcomas of lung are rare compared to metastatic sarcomas. Herein, we report a rare case of primary pulmonary synovial sarcoma with polypoid endobronchial growth in a 35-year-old lady who presented with cough and dyspnea. A malignant pulmonary tumor was suspected and left pneumonectomy was performed. Grossly, a non-encapsulated polypoidal endobronchial tumor measuring 6 cm in greatest diameter, with a solid, tan-white cut surface was identified. Microscopically, tumor was characterized by a proliferation of oval to spindle-shaped cells arranged in sheets and fascicles. Focal hemangiopericytomatous pattern was noted. Immunohistochemically, tumor cells were positive for vimentin, BCL-2, MIC-2 and calponin and focally positive for pancytokeratin and epithelial membrane antigen. A subsequent molecular analysis performed using reverse transcriptase-polymerase chain reaction with RNA extracted from paraffin-embedded tissue, revealed SYT/SSX1 fusion gene which confirmed the diagnosis of synovial sarcoma. The utility of immunohistochemistry and molecular techniques in diagnosis of such a rare case is stressed and the relevant literature is discussed.
ABSTRACT
Most malignant mesenchymal tumors of the lung are metastases of a primary tumor from elsewhere in the body. A primary pulmonary synovial sarcoma is a very rare neoplasm that accounts for approximately 10% of soft tissue sarcomas and makes up only 0.5% of all primary lung malignancies. We report a case of a primary pulmonary synovial sarcoma in a 60-year old woman. In this case, a lung metastasis was excluded using 18F-FDG PET /CT imaging.