Primary monophasic synovial sarcoma of the lung: Rare case report

Figures

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  Fig. 1. Primary monophasic synovial sarcoma of lung (A,B) NCCT and (C)lung window axial images show soft tissue attenuation mass lesions in bilateral hemithorax, without any calcification or air bronchogram within the masses.

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  Fig. 2. Primary monophasic synovial sarcoma of lung (A, B) axial and (C, D) sagittal contrast enhanced CT show few heterogeneously enhancing masses with areas of necrosis in bilateral hemithorax, with indistinct plane with heart (thin white arrow), abutting the main pulmonary artery (black long arrow) and displacing the abdominal aorta anteriorly (white long arrow), indenting the liver inferiorly (white short arrow).

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  Fig. 3. Primary monophasic synovial sarcoma of lung, coronal: (A) heterogeneously enhancing masses with indistinct planes with the heart (long white arrow), (B) the mass is abutting the descending thoracic aorta (long black arrow), (C) it is inferiorly indenting the right kidney (short white arrow) and abutting the vertebral bodies with no obvious bony erosion seen (short black arrow).

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  Fig. 5. Primary monophasic synovial sarcoma of lung, lung window (coronal, sagittal and axial): an irregular soft tissue attenuation mass in right lung with surrounding ground glass opacity, no air bronchogram seen within the lesion.

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  Fig. 6. Primary monophasic synovial sarcoma of lung, contrast enhanced CT: (A) coronal image showing an irregular heterogeneously enhancing mass in right lung, abutting right hilum and involving the adjacent costal pleura (white arrows) with focal eventration (yellow asterisk).

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  Fig. 7. Primary monophasic synovial sarcoma of lung; (B, C) FDG PET scan 3D tracer uptake noted in right lung mass. (Thin long and thick short black arrows) and (A, D) fusion image showing uptake in right lung mass (thin long and thick short white arrows).

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  Fig. 4. Primary monophasic synovial sarcoma of lung:(A- 20x, B-40x) Hematoxylin & Eosin stain shows fairly uniform spindle shaped cells with dispersed chromatin, inconspicuous nucleoli and moderate amount of pale cytoplasm. Few mitoses are also evident, (C) Pan cytokeratin negativity (D) TLE-1 positivity (E) Bcl2 positivity (F) vimentin positivity [20x].

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  Fig. 8. Primary monophasic synovial sarcoma of lung:(A-20x, B-40x) Hematoxylin & Eosin stain shows spindle shaped cells with inconspicuous nucleoli and moderate amount of pale cytoplasm, (C) TLE-1 positivity (D) Bcl2 positivity (E) EMA negativity [20x].