We describe a case of primary pulmonary synovial sarcoma arising in the lung of a 35-year-old woman.The tumor was a single mass and had a well-defined pleural-based with homogeneous density in the edge of the middle l...We describe a case of primary pulmonary synovial sarcoma arising in the lung of a 35-year-old woman.The tumor was a single mass and had a well-defined pleural-based with homogeneous density in the edge of the middle lobe,with no calcification and a fat component on plain CT scan.On the contrast-enhanced CT scan,the tumor showed moderately enhancement and circular enhancement with no enlargement of mediastinal,hilar lymph nodes.Skeleton single photon emission CT(ECT) was unremarkable.Gross and histological findings by postoperative pathology showed the tumor had pseudo-capsule and was well-circumscribed with foci of necrosis,hemorrhage and cystic change,under microscope tumor was typically mitotically active,spindle cells growing in intersecting fascicles or in solid sheets with epithelial differentiation.The immunohistochemical examination of CD99,Vim,PCK and EMA were positive.The tumor recurred with multiple pleural nodules and mass at 5 months after surgery,chest CT revealed the tumor was in the ipsilateral costophrenic angle for chest pain of the patient.After dynamic contrast-enhanced,the solid parts and the capsule of the lesion showed progressive enhancement and the liquefied area of the lesion without enhancement.This case indicates that a primary pulmonary synovial sarcoma is extremely rare and malignant,its prognosis is poor.There are some relatively specific imaging findings.展开更多
Objective: The aim of this study was to investigate the imaging findings of intrathoracic solitary fibrous tumor (SFT), so as to improve its diagnosis and differential diagnosis. Methods: The clinical, imaging and pat...Objective: The aim of this study was to investigate the imaging findings of intrathoracic solitary fibrous tumor (SFT), so as to improve its diagnosis and differential diagnosis. Methods: The clinical, imaging and pathological data of three intrathoracic SFTs confirmed by surgical pathology were analyzed retrospectively. There three cases all received spiral CT plain scan and enhanced scan, among which two multi-planar reformation (MPR) and one MR plain scan. And literatures were reviewed to investigate the imaging findings of intrathoracic SFT. Results: The three intrathoracic SFT located at intra-pulmonary, oblique fissure pleura and posterior chest wall visceral pleura, respectively. All were solitary masses. One case was a peripheral lung mass at dorsal segment of left lower lobe which CT plain scan showed as a soft tissue mass well circumscribed, enhanced scan showed that there were enhanced clustered, lineal small vascular signs in the mass during arterial phase, delayed scanning displayed that the mass showed heterogeneous enhancement and parts of solid content showed gradual enhancement, and there were shorter T1 signals on MRI T1WI, map-like high-low mixed signals on T2WI, mainly with short T2 signals. One case was an oblique fissure mass which plain scan showed as a homogeneous soft tissue mass with oval in shape and smooth edge, and enhanced scan showed moderate homogeneous enhancement. One case was a mass localized at posterior chest wall visceral pleura which CT plain scan showed as a heterogeneous mass, and enhanced scan showed that there was slight ring-like enhancement, large non-enhancing necrosis area in the mass and facing vessels in the vicinity region. All these three cases had no hilar and mediastinal lymphadenectasis. Operation and pathology results showed that the mass was well circumscribed, with capsule or false capsule. Under microscope, tumor cells were long fusiform, presenting bundle, turbulence or irregular arrangement. Hypocellular and hypercellular area appeared alternately, with interspersed coarse scar-like collagen fibers with hyalinization. There were hemangiopericytoma-like structures under parts of visual fields. There were bronchiole and alveolar epithelium in the legion at dorsal segment of left lower lobe in one case. The results of immunohistochemistry showed that the expressions of CD34 or CD99, Bcl-2 and vimentin were all strong positive. Conclusion: Intrathoracic SFT might be rare, which imaging findings could have relative characteristic features and diagnosis must depend on histopathology and immunohistochemistry examination.展开更多
文摘We describe a case of primary pulmonary synovial sarcoma arising in the lung of a 35-year-old woman.The tumor was a single mass and had a well-defined pleural-based with homogeneous density in the edge of the middle lobe,with no calcification and a fat component on plain CT scan.On the contrast-enhanced CT scan,the tumor showed moderately enhancement and circular enhancement with no enlargement of mediastinal,hilar lymph nodes.Skeleton single photon emission CT(ECT) was unremarkable.Gross and histological findings by postoperative pathology showed the tumor had pseudo-capsule and was well-circumscribed with foci of necrosis,hemorrhage and cystic change,under microscope tumor was typically mitotically active,spindle cells growing in intersecting fascicles or in solid sheets with epithelial differentiation.The immunohistochemical examination of CD99,Vim,PCK and EMA were positive.The tumor recurred with multiple pleural nodules and mass at 5 months after surgery,chest CT revealed the tumor was in the ipsilateral costophrenic angle for chest pain of the patient.After dynamic contrast-enhanced,the solid parts and the capsule of the lesion showed progressive enhancement and the liquefied area of the lesion without enhancement.This case indicates that a primary pulmonary synovial sarcoma is extremely rare and malignant,its prognosis is poor.There are some relatively specific imaging findings.
文摘Objective: The aim of this study was to investigate the imaging findings of intrathoracic solitary fibrous tumor (SFT), so as to improve its diagnosis and differential diagnosis. Methods: The clinical, imaging and pathological data of three intrathoracic SFTs confirmed by surgical pathology were analyzed retrospectively. There three cases all received spiral CT plain scan and enhanced scan, among which two multi-planar reformation (MPR) and one MR plain scan. And literatures were reviewed to investigate the imaging findings of intrathoracic SFT. Results: The three intrathoracic SFT located at intra-pulmonary, oblique fissure pleura and posterior chest wall visceral pleura, respectively. All were solitary masses. One case was a peripheral lung mass at dorsal segment of left lower lobe which CT plain scan showed as a soft tissue mass well circumscribed, enhanced scan showed that there were enhanced clustered, lineal small vascular signs in the mass during arterial phase, delayed scanning displayed that the mass showed heterogeneous enhancement and parts of solid content showed gradual enhancement, and there were shorter T1 signals on MRI T1WI, map-like high-low mixed signals on T2WI, mainly with short T2 signals. One case was an oblique fissure mass which plain scan showed as a homogeneous soft tissue mass with oval in shape and smooth edge, and enhanced scan showed moderate homogeneous enhancement. One case was a mass localized at posterior chest wall visceral pleura which CT plain scan showed as a heterogeneous mass, and enhanced scan showed that there was slight ring-like enhancement, large non-enhancing necrosis area in the mass and facing vessels in the vicinity region. All these three cases had no hilar and mediastinal lymphadenectasis. Operation and pathology results showed that the mass was well circumscribed, with capsule or false capsule. Under microscope, tumor cells were long fusiform, presenting bundle, turbulence or irregular arrangement. Hypocellular and hypercellular area appeared alternately, with interspersed coarse scar-like collagen fibers with hyalinization. There were hemangiopericytoma-like structures under parts of visual fields. There were bronchiole and alveolar epithelium in the legion at dorsal segment of left lower lobe in one case. The results of immunohistochemistry showed that the expressions of CD34 or CD99, Bcl-2 and vimentin were all strong positive. Conclusion: Intrathoracic SFT might be rare, which imaging findings could have relative characteristic features and diagnosis must depend on histopathology and immunohistochemistry examination.
