One Case Report About Primary Pulmonary Synovial Sarcoma And Literatures Review

Objectives Synovial sarcoma is a malignant soft tissue tumors of uncertain type. Primary pulmonary synovial sarcoma is exceptional.Surgeons were not familiar with the disease because it rarely happened. synovial sarcoma as easily misdiagnosed as other kinds of soft tissue tumor or chronic inflammation. A case of primary pulmonary synovial sarcoma was treated in my hospital,now the report combining with documents is about this sarcoma from clinical presentation , histopathology, immunochemistry, molecular biology, treatment and prognosis to review,the aim is to know more about the sarcoma in later clinical practice .Methods A retrospective study was performed in 67 cases of primary pulmonary synovial sarcoma combining with one patient with primary pulmonary synovial sarcoma who was diagnosed recently in Qilu hospital with medical history, radiographic ,due to the further study of pathological manifestations, immunochemistry, molecular biology to make correct diagnosis and differential diagnosis,lead to treat and make prognosis.Results In the 67 cases of primary pulmonary synovial sarcoma ,male 29 ,female 38,the youngest is 12 ,the oldest is 81 ,the middle age is 42. The main clinical manifestations of primary pulmonary synovial sarcoma is cough,chest pain ,hemoptysis and fever and so on .The main changes of the chest CT (1) primary pulmonary synovial sarcoma can grow in any pulmonary lobe, in the lung the tumor is uneven parenchymatous bolus shadow , the diameter >5CM ,borderline is clear ,uneven augmentation, sublobe is not obviously, usually is incisure or cast form changed. (2) the tumor is usually calcification,mang kinds .(3)the tumor is often to encroach on pleura to cause pleural effussion . Immunohistochemically,the tumor cells were positive for CK,EMA,Vim.About 90% patients had the fusion gene SYT-SSX. The last diagnose depened on pathology,immunohistochemical supported it. The five year survival rate is 50%.Conclusions Primary pulmonary synovial sarcoma was the exceptional malignant tumor , the main clinical manifestations and CT was untype.It was misdiagnosed other type tumor or inflammation easily.It could be final diagnosed by clinic ,pathology,immunohistochemical and fusion gene. The exairesis is the main therapy,not totally exairesis leaded to bad prognosis.