pleural synovial sarcoma

Tumor and

tumorlike conditions of the pleura and juxtapleural region: review of imaging findings. Diagnosis: synovial sarcoma. Technique: contrast-enhanced chest CT and 18FDG-PET CT. Description: A 43-year old woman with a history of a synovial sarcoma in the sartorius muscle was referred for a chest CT to rule out metastatic disease. Axial contrast-enhanced CT (a) shows a lobulated, well-defined pleural lesion (arrow) in the base of the right lung, which is slightly heterogeneous (see detail image b). There is no increased FDG uptake on the 18-F-FDG PET examination (c). Histopathologic examination of the resected specimen confirmed the diagnosis of synovial sarcoma

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Pleural

synovial sarcoma. Expiratory chest radiograph demonstrates a moderate to large left pleural effusion with superimposed consolidation, initially interpreted as pneumonia with parapneumonic effusion. There is also a rounded opacity in the left suprahilar region, concerning for mass.

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Pleural

synovial sarcoma. Coronal (A) and axial (b) non-contrasted chest CT images demonstrate a rounded posterior mediastinal mass with associated left pleural effusion and left lower lobe atelectasis.

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Pleural

synovial sarcoma. Coronal (A) and axial (b) non-contrasted chest CT images demonstrate a rounded posterior mediastinal mass with associated left pleural effusion and left lower lobe atelectasis.

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Pleural synovial sarcoma is a rare tumor and refers to a primary synovial sarcoma arising from the pleura. It together with primary synovial sarcoma of the lung comes under the broader category of pleuro-pulmonary synovial sarcomas.

Epidemiology

They are thought to comprise <1% of all primary lung malignancies . They typically occur in adolescents and young adults (between the ages of 15 and 40 years).

Pathology

Their histological characteristics may be mistaken for those of malignant mesothelioma or other spindle cell tumors. Historically they are believed to originate from primitive pluripotent mesenchyme capable of synovial differentiation.