Primary endobronchial synovial sarcoma confirmed by SYT-SSX1 fusion gene transcript by reverse transcriptase polymerase chain reaction

Indian J Pathol Microbiol. 2009 Oct-Dec;52(4):520-3. doi: 10.4103/0377-4929.56147.

Abstract

Primary sarcomas of lung are rare compared to metastatic sarcomas. Herein, we report a rare case of primary pulmonary synovial sarcoma with polypoid endobronchial growth in a 35-year-old lady who presented with cough and dyspnea. A malignant pulmonary tumor was suspected and left pneumonectomy was performed. Grossly, a non-encapsulated polypoidal endobronchial tumor measuring 6 cm in greatest diameter, with a solid, tan-white cut surface was identified. Microscopically, tumor was characterized by a proliferation of oval to spindle-shaped cells arranged in sheets and fascicles. Focal hemangiopericytomatous pattern was noted. Immunohistochemically, tumor cells were positive for vimentin, BCL-2, MIC-2 and calponin and focally positive for pancytokeratin and epithelial membrane antigen. A subsequent molecular analysis performed using reverse transcriptase-polymerase chain reaction with RNA extracted from paraffin-embedded tissue, revealed SYT/SSX1 fusion gene which confirmed the diagnosis of synovial sarcoma. The utility of immunohistochemistry and molecular techniques in diagnosis of such a rare case is stressed and the relevant literature is discussed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bronchial Neoplasms / diagnosis*
  • Bronchial Neoplasms / pathology
  • Bronchial Neoplasms / physiopathology
  • Bronchial Neoplasms / surgery
  • Female
  • Gene Expression Profiling / methods*
  • Histocytochemistry
  • Humans
  • Immunohistochemistry
  • Oncogene Proteins, Fusion / genetics*
  • Radiography, Thoracic
  • Reverse Transcriptase Polymerase Chain Reaction / methods*
  • Sarcoma, Synovial / diagnosis*
  • Sarcoma, Synovial / pathology
  • Sarcoma, Synovial / physiopathology
  • Sarcoma, Synovial / surgery

Substances

  • Oncogene Proteins, Fusion
  • SYT-SSX fusion protein