title: Synovial sarcoma presenting as a lung mass and diagnosed by cytology.
abstract: Synovial sarcoma is a common soft tissue sarcoma with variable fibrous and epithelial differentiation that rarely arises from other body sites, such as within the lung. A case of a 68-year-old male with an extensive smoking history who presented with chest pain and a primary, central, metabolically active lung mass was reported. The mass was biopsied by bronchial brushing, bronchoalveolar lavage (BAL), and transbronchial fine-needle aspiration (FNA). Cytologic analysis of bronchial brushing, BAL, and FNA revealed single and clusters of atypical spindle cells, oval, or spindle-shaped nuclei with smooth nuclear membranes, hyperchromatic and granular chromatin, scant to moderate and delicate cytoplasm, a high degree of mitotic figures, and a lack of necrosis. Immunohistochemical studies showed that the tumor cells were positive for CD99, BCL2, and CK7. A diagnosis of synovial sarcoma was rendered. The differential diagnosis of primary pulmonary synovial sarcoma is discussed, including neuroendocrine tumors, squamous cell carcinoma, and various sarcomatous tumors.
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Pyden
authors.affiliation: Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Lin
mesh_terms: D000368:Aged; D044963:Biopsy, Fine-Needle; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D002277:Carcinoma / Q000473:pathology*; D002467:Cell Nucleus / Q000473:pathology; D002843:Chromatin / Q000473:pathology; D003593:Cytoplasm / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D018358:Neuroendocrine Tumors / Q000473:pathology*; D013584:Sarcoma, Synovial / Q000473:pathology*; D012983:Soft Tissue Neoplasms / Q000473:pathology*
chemical_list: D002843:Chromatin
keywords: bronchial brushing; bronchoalveolar lavage; fine needle aspiration; immunohistochemistry; synovial sarcoma