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Lee, Lee, Kwag, Kim, Oh, Lim, and Lim: A Case of Monophasic Fibrous Synovial Sarcoma Confirmed Primary Pulmonary Origin by 18F-FDG PET/CT
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 60(6): 673-677.

Published online: 30 June 2006

DOI: https://doi.org/10.4046/trd.2006.60.6.673

A Case of Monophasic Fibrous Synovial Sarcoma Confirmed Primary Pulmonary Origin by 18F-FDG PET/CT

Eun A Lee, M.D., Do Young Lee, M.D., Hyon Joo Kwag, M.D.1, Min Kyung Kim, M.D.2, Tae Yun Oh, M.D.3, Si Young Lim, M.D., Seong Yong Lim, M.D.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

1Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

2Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

3Department of Thoracic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address for correspondence: Seong Yong Lim, M.D. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-dong, Jongno-ku, Seoul 110-746, Korea. Phone: (822) 2001-2491, FAX: (822) 2001-2049, mdlimsy@skku.edu

Received 18 April 2006       Accepted 7 June 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

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.

Keywords: Primary pulmonary synovial sarcoma, FDG PET/CT

Figures and Tables

Figure 1
(A) Chest radiograph shows right lower lobe mass. (B) On chest CT scan, 5×4cm sized well demarcated and highly enhancing mass was noted in right lower lobe.
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Figure 2
(A) FDG PET coronal image: FDG PET scan reveals increased FDG uptake foci in right lower lobe (peak SUV=3.7). (B) FDG PET fused coronal image: fusion PET demonstrated mild hypermetabolic mass in right lower lobe.
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Figure 3
The cut surface of the resected lung shows a relatively well demarcated pale yellow tan solid mass with fish flesh-like appearance. The bronchial tree is grossly intact.
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Figure 4
Light microscopic finding shows that tumor is composed of highly cellular spindle cells with long intersecting fascicular arrangement and mild to moderate atypism (H&E, ×400).
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Figure 5
The results of immunohistochemical stains. The tumor cells are completely negative for smooth muscle actin (A; ×400) and CD34 (B; ×400). The majority of tumor cells show strong and diffuse positive reaction for bcl-2 (C; ×400) and vimentin (D; ×400).
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