Abstract
Primary synovial sarcoma (SS) and solitary fibrous tumor (SFT) are both uncommon pulmonary mesenchymal neoplasms. Clinically and morphologically, monophasic SS can closely mimic SFT. Both SS and SFT are predominantly pleural-based tumors composed of monotonous spindle cells accompanied by staghorn-like blood vessels. Immunohistochemically, both tumors can express EMA, CD99, BCL2, and other nonspecific markers. Pulmonary SS is an aggressive neoplasm with a poor survival rate, while SFT generally follows an indolent behavior with most patients cured by complete resection. Thus, correct diagnosis is crucial for patient care. In this chapter, we describe the clinical and pathologic features of SS and SFT, and summarize the histologic, immunohistochemical, and molecular features that are helpful in distinguishing between these two neoplasms.
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References
Fletcher CDM, Dacic S, Ladanyi M. Synovial sarcoma. In: Travis WD, Brambilla E, Burke AP, Marx A, Cicholson AG, editors. WHO classification of tumours of the lung, pleura, thymus, and heart. 4th ed. Lyon: IARC Press; 2015.
Goldblum JR, Folpe AL, Weiss SW. Other malignant soft tissue tumors, including those of uncertain type. In: Enzinger & Weiss’s soft tissue tumors. 7th ed. Amsterdam: Elsevier; 2019: 175-1270.
Cummings NM, Desai S, Thway K, Stewart S, Hill DA, Priest JR, et al. Cystic primary pulmonary synovial sarcoma presenting as recurrent pneumothorax: report of 4 cases. Am J Surg Pathol. 2010;34(8):1176–9.
Johnson ED, Downs-Kelly E, Bull DA, Gulbahce HE. Primary cystic pleuropulmonary synovial sarcoma presenting as recurrent pneumothorax. Case Rep Oncol. 2017;10(2):660–5.
Guo C, Liu C, Pu Q, Lin F, Liu L. Occult primary pulmonary synovial sarcoma presenting as recurrent spontaneous pneumothorax and explosive progression. Thorac Cancer. 2017;8(2):121–3.
Petrosyan A, Bergeron P. Extensive surgical treatment of primary pulmonary synovial sarcoma after recurrent pneumothorax. Ann Thorac Surg. 2015;100(5):1893–5.
Lan T, Chen H, Xiong B, Zhou T, Peng R, Chen M, et al. Primary pleuropulmonary and mediastinal synovial sarcoma: a clinicopathologic and molecular study of 26 genetically confirmed cases in the largest institution of Southwest China. Diagn Pathol. 2016;11(1):62.
Goldblum JR, Folpe AL, Weiss SW. Soft tissue tumors of intermediate malignancy of uncertain type. In: Enzinger & Weiss’s soft tissue tumors. 7th ed. Amsterdam: Elsevier; 2019: 107-1174.
Fletcher CDM, Gibbs A. Solitary fibrous tumor. In: Travis WD, Brambilla E, Burke AP, Marx A, Cicholson AG, editors. WHO classification of tumours of the lung, pleura, thymus, and heart. 4th ed. Lyon: IARC Press; 2015.
Demicco EG, Wagner MJ, Maki RG, Gupta V, Iofin I, Lazar AJ, Wang WL. Risk assessment in solitary fibrous tumors: validation and refinement of a risk stratification model. Mod Pathol. 2017;30(10):1433–42.
Kosemehmetoglu K, Vrana JA, Folpe AL. TLE1 expression is not specific for synovial sarcoma: a whole section study of 163 soft tissue and bone neoplasms. Mod Pathol. 2009;22(7):872–8.
Demicco EG, Harms PW, Patel RM, Smith SC, Ingram D, Torres K, et al. Extensive survey of STAT6 expression in a large series of mesenchymal tumors. Am J Clin Pathol. 2015;143(5):672–82.
Robinson DR, Wu YM, Kalyana-Sundaram S, Cao X, Lonigro RJ, Sung YS, et al. Identification of recurrent NAB2-STAT6 gene fusions in solitary fibrous tumor by integrative sequencing. Nat Genet. 2013;45(2):180–5.
Creytens D, Libbrecht L, Ferdinande L. Nuclear expression of STAT6 in dedifferentiated liposarcomas with a solitary fibrous tumor-like morphology: a diagnostic pitfall. Appl Immunohistochem Mol Morphol. 2015;23(6):462–3.
Doyle LA, Tao D, Mariño-Enríquez A. STAT6 is amplified in a subset of dedifferentiated liposarcoma. Mod Pathol. 2014;27(9):1231–7.
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Zhu, H. (2022). Synovial Sarcoma Versus Solitary Fibrous Tumor. In: Xu, H., Ricciotti, R.W., Mantilla, J.G. (eds) Practical Lung Pathology. Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-031-14402-8_25
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DOI: https://doi.org/10.1007/978-3-031-14402-8_25
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