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| CT features of peripheral type of primary pulmonary synovial sarcoma and literature review |
| WANG Guo-yu, WANG Bin, HUANG Shu-jia, XU Zu-liang, WU Yu-lin |
| Department of Radiology, Taizhou Central Hospital, Affiliated Hospital of Taizhou College, Taizhou Zhejiang 318000, China |
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Abstract Objective: To investigate the CT findings and clinical features of peripheral type of primary pulmonary synovial sarcoma(PPSS). Methods: The clinical data and CT imaging characteristics of 6 cases with pathologically-proved peripheral type of PPSS were retrospectively analyzed. All 6 cases received con-contrast scan and enhanced chest scan with spiral CT, and 3 cases underwent multiplanar reconstruction. Results: Of the 6 cases, 1 case was male and 5 cases were female, with an average age of 47.2 years, all the cases were single phase type of synovial sarcoma confirmed by pathology. There were 2 cases with single lesion and 4 cases with multiple lesions, a total of 12 lesions, 10 of which were circular or quasi-circular, 2 of which were irregular shape, 8 of which had clear boundaries, and 4 of which had blurred boundaries, invading the chest wall or pleura. The density of 7 lesions was uneven, accompanied by liquefaction necrosis and uneven enhancement, with an average size of 70.3 mm. The density of the other 5 lesions was even, with no liquefaction necrosis area, with an average size of 30.8 mm, the two groups were statistically significant(P=0.005<0.05). No calcification was found in all lesions. The CT values of the solid part of the lesion in plain scan and enhanced dual-phase scan were about 46.8 HU, 70.7 HU and 93.4 HU. Vascular signs were found in 5 lesions. Four patients were accompanied by pleural effusion, 2 of which had high pleural effusion density. One patient was accompanied by enlargement of right hilum and para-esophageal lymph nodes. Conclusion: Peripheral type of PPSS usually has large lesions, and when the tumor is larger, it is easier to liquefy necrosis, and the part of solid was mild to moderate continuous enhancement in enhanced CT imaging. Enhanced CT has certain significance, especially when the tumor is multiple or the pleural effusion density is increased, differential diagnosis is needed.
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Received: 27 November 2019
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