Imaging findings of primary synovial sarcoma of the lung
Chinese Journal of Radiology(2009)
摘要
Objective: To evaluate the imaging characteristics of primary pulmonary synovial sarcoma and improve its diagnosis and differential diagnosis. Methods: The clinical, imaging and pathology findings of 5 patients were retrospectively analyzed. All 5 patients received X-ray and CT scan, 1 case had MRI and PET-CT examination. SYT-SSX fusion gene was analyzed in 4 patients using reverse transcriptase-polymerase chain reaction (RT-PCR). Results: All the 5 patients had solid mass in the lungs and their diameter were 5.3 to 15.7 cm. One was associated with pneumothorax and the others were with moderate pleural effusion. Peripheral tumors, which showed clear margin partly with inhomogeneous density, was found in CT scan. On the contrast-enhanced CT scan, 3 cases were inhomogeneous enhancement and 2 were circular enhancement. Pleural invasion or conglutination was detected in 5 patients. No hilar or mediastinal lymph nodes metastasis were seen in all cases. MRI showed intermediate signal on T 1WI and heterogeneous on T 2WI of one case with right upper lobe lesion and showed thick mural enhancement after Gadolinium enhancement. The adjacent chest wall, rib thoracic vertebra, vertebral canal and thoracic cord were invaded. PET-CT showed increased uptake of FDG (SUV = 12.3) in tumors. The immunohistochemical examination of Vim, CK and EMA were positive and SYT-SSX gene was detected in 4 patients. Conclusions: There are some relatively specific imaging findings of primary pulmonary synovial sarcoma. However it is necessary for diagnosing the disease to combine pathology, immunohistochemistry and SYT-SSX gene detection. © 2009 by the Chinese Mecdical Association.
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关键词
Lung neoplasms,Pathology,Sarcoma, synovial,Tomography, X-ray computed
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