Primary synovial sarcoma of lung.

Area of Science:

• Oncology
• Pathology
• Radiology

Background:

• Synovial sarcoma (SS) is a rare malignancy typically arising near joints but can occur in diverse tissues.
• Primary pulmonary synovial sarcoma is exceptionally rare, posing diagnostic challenges.

Purpose of the Study:

• To report a rare case of primary pulmonary synovial sarcoma.
• To highlight the diagnostic features and methodology for this rare tumor.

Main Methods:

• Computed tomography (CT) scan of the thorax for initial imaging.
• CT-guided core biopsy for tissue acquisition.
• Immunohistochemistry (IHC) for definitive diagnosis.

Main Results:

• The patient presented with severe chest pain and a large right lung mass with pleural effusion on CT.
• Immunohistochemistry revealed tumor cells expressing EMA, bcl 2, Vimentin, and smooth muscle actin.
• Tumor cells were immunonegative for S100 and cytokeratin, supporting the diagnosis.

Conclusions:

• Primary pulmonary synovial sarcoma is an extremely rare entity.
• CT-guided biopsy and IHC are crucial for diagnosing primary pulmonary SS.
• This case underscores the importance of considering rare diagnoses in pulmonary masses.