An unexpected cause of recurrent pneumothorax
Giulio Rossi1, Anna Farnedi2, Fabio Davoli3
1Operative Unit of Pathologic Anatomy, Fondazione Poliambulanza Hospital Institute, Brescia, Italy.
Pathologica
|September 22, 2022
Summary
Pulmonary cystic monophasic synovial sarcoma is a rare lung cancer presenting as a cyst. Early detection requires careful examination of pneumothorax tissue and molecular studies for accurate diagnosis.
Area of Science:
- Oncology
- Thoracic Surgery
- Pathology
Background:
- Synovial sarcoma commonly affects the thoracic region, typically presenting as large solid masses in the lung or pleura.
- Recurrent pneumothorax can be an unusual initial presentation of thoracic malignancies.
Observation:
- A 57-year-old male presented with recurrent pneumothorax and a lingular bulla.
- Surgical excision revealed a unilocular cyst with spindle cell proliferation expressing EMA, CD99, CD56, and cytokeratins.
Findings:
- Fluorescent in situ hybridization confirmed SYT rearrangement, leading to a diagnosis of pulmonary cystic monophasic synovial sarcoma.
- This extremely rare condition, primarily reported in young males, was found in a cyst associated with pneumothorax.
Implications:
- Meticulous examination of pneumothorax-related resected tissue is crucial for suspecting this rare entity.
- Immunohistochemical and molecular analyses are essential for definitive diagnosis of pulmonary cystic synovial sarcoma.
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