Synovial sarcoma - Revision history

Michael: tweak

2014-01-23T17:35:57Z

tweak

← Older revision		Revision as of 17:35, 23 January 2014
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	*[http://www.tumorlibrary.com/case/detail.jsp?image_id=2462 SS (tumorlibrary.com)].		*[http://www.tumorlibrary.com/case/detail.jsp?image_id=2462 SS (tumorlibrary.com)].

	===Microscopic===		==Microscopic==
	Comes in three (histologic) flavours:<ref name=Ref_WMSP627>{{Ref WMSP\|627}}</ref><ref>{{cite journal \|author=Schaal CH, Navarro FC, Moraes Neto FA \|title=Primary renal sarcoma with morphologic and immunohistochemical aspects compatible with synovial sarcoma \|journal=Int Braz J Urol \|volume=30 \|issue=3 \|pages=210–3 \|year=2004 \|pmid=15689250 \|doi= \|url=http://www.brazjurol.com.br/may_june_2004/Schaal_ing_210_213.htm}}</ref>		Comes in three (histologic) flavours:<ref name=Ref_WMSP627>{{Ref WMSP\|627}}</ref><ref>{{cite journal \|author=Schaal CH, Navarro FC, Moraes Neto FA \|title=Primary renal sarcoma with morphologic and immunohistochemical aspects compatible with synovial sarcoma \|journal=Int Braz J Urol \|volume=30 \|issue=3 \|pages=210–3 \|year=2004 \|pmid=15689250 \|doi= \|url=http://www.brazjurol.com.br/may_june_2004/Schaal_ing_210_213.htm}}</ref>
	#Spindle cell sarcoma with features of hemangiopericytoma, i.e. [[staghorn vessels]].		#Spindle cell sarcoma with features of hemangiopericytoma, i.e. [[staghorn vessels]].
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	**Can be difficult.		**Can be difficult.

	====Images====		===Images===
	<gallery>		<gallery>
	Image:Monophasic_synovial_sarcoma_-_intermed_mag.jpg \| Monophasic synovial sarcoma with staghorn vessels - intermed. mag. (WC/Nephron)		Image:Monophasic_synovial_sarcoma_-_intermed_mag.jpg \| Monophasic synovial sarcoma with staghorn vessels - intermed. mag. (WC/Nephron)
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	*[http://radiographics.rsna.org/content/26/5/1543.long Monophasic SS (radiographics.rsna.org)].		*[http://radiographics.rsna.org/content/26/5/1543.long Monophasic SS (radiographics.rsna.org)].

	===IHC===		==IHC==
	Features:<ref name=Ref_WMSP627>{{Ref WMSP\|627}}</ref>		Features:<ref name=Ref_WMSP627>{{Ref WMSP\|627}}</ref>
	*Vimentin +ve.		*Vimentin +ve.
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	*PGP in ''PGP9.5'' = protein gene product.<ref name=pmid6343558>{{Cite journal \| last1 = Doran \| first1 = JF. \| last2 = Jackson \| first2 = P. \| last3 = Kynoch \| first3 = PA. \| last4 = Thompson \| first4 = RJ. \| title = Isolation of PGP 9.5, a new human neurone-specific protein detected by high-resolution two-dimensional electrophoresis. \| journal = J Neurochem \| volume = 40 \| issue = 6 \| pages = 1542-7 \| month = Jun \| year = 1983 \| doi = \| PMID = 6343558 }}</ref>		*PGP in ''PGP9.5'' = protein gene product.<ref name=pmid6343558>{{Cite journal \| last1 = Doran \| first1 = JF. \| last2 = Jackson \| first2 = P. \| last3 = Kynoch \| first3 = PA. \| last4 = Thompson \| first4 = RJ. \| title = Isolation of PGP 9.5, a new human neurone-specific protein detected by high-resolution two-dimensional electrophoresis. \| journal = J Neurochem \| volume = 40 \| issue = 6 \| pages = 1542-7 \| month = Jun \| year = 1983 \| doi = \| PMID = 6343558 }}</ref>

	===EM===		==EM==
	Features:<ref name=pmid9930576>{{Cite journal \| last1 = Fisher \| first1 = C. \| title = Synovial sarcoma. \| journal = Ann Diagn Pathol \| volume = 2 \| issue = 6 \| pages = 401-21 \| month = Dec \| year = 1998 \| doi = \| PMID = 9930576 }}</ref>		Features:<ref name=pmid9930576>{{Cite journal \| last1 = Fisher \| first1 = C. \| title = Synovial sarcoma. \| journal = Ann Diagn Pathol \| volume = 2 \| issue = 6 \| pages = 401-21 \| month = Dec \| year = 1998 \| doi = \| PMID = 9930576 }}</ref>
	*Biphasic tumour have biphasic ultrastructural features (unlike spindle cell carcinoma and [[epithelioid sarcoma]]).		*Biphasic tumour have biphasic ultrastructural features (unlike spindle cell carcinoma and [[epithelioid sarcoma]]).
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	**No intermediate filaments, no myofilaments.		**No intermediate filaments, no myofilaments.

	===Molecular pathology===		==Molecular pathology==
	Associated [[translocation]]:		Associated [[translocation]]:
	*t(X;18)(p11.2;q11.2).<ref>URL: [http://www.ncbi.nlm.nih.gov/omim/300813 http://www.ncbi.nlm.nih.gov/omim/300813]. Accessed on: 30 May 2010.</ref>		*t(X;18)(p11.2;q11.2).<ref>URL: [http://www.ncbi.nlm.nih.gov/omim/300813 http://www.ncbi.nlm.nih.gov/omim/300813]. Accessed on: 30 May 2010.</ref>

Michael: more

2013-09-23T04:58:54Z

← Older revision		Revision as of 04:58, 23 September 2013
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	[[Category:Diagnosis]]		[[Category:Diagnosis]]
			[[Category:Soft tissue lesions]]

Michael at 04:57, 23 September 2013

2013-09-23T04:57:49Z

← Older revision		Revision as of 04:57, 23 September 2013
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	\| Width =		\| Width =
	\| Caption = Monophasic synovial sarcoma. [[H&E stain]].		\| Caption = Monophasic synovial sarcoma. [[H&E stain]].
	\| Micro = one of the following (1) spindle cell sarcoma with features of hemangiopericytoma, i.e. [[staghorn vessels]]; (2) biphasic synovial sarcoma (spindle cells with features of hemangiopericytoma, epitheliod glands or nests); (3) primitive round cell type		\| Micro = one of the following: (1) spindle cell sarcoma with features of [[hemangiopericytoma]], i.e. [[staghorn vessels]]; (2) biphasic synovial sarcoma (spindle cells with features of hemangiopericytoma, epitheliod glands or nests); (3) primitive round cell type
	\| Subtypes =		\| Subtypes =
	\| LMDDx = [[MPNST]], [[fibrosarcoma]], [[small round cell tumours]]		\| LMDDx = [[MPNST]], [[hemangiopericytoma]], [[fibrosarcoma]], [[small round cell tumours]], carcinoma
	\| Stains =		\| Stains =
	\| IHC = Vimentin +ve, EMA +ve, BCL2 +ve, CD99 +ve.		\| IHC = Vimentin +ve, EMA +ve, BCL2 +ve, CD99 +ve.

Michael: split-out

2013-09-23T04:55:42Z

split-out

← Older revision		Revision as of 04:55, 23 September 2013
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	#~~redirect~~ [[~~Soft_tissue_lesions~~#Synovial sarcoma]]		{{ Infobox diagnosis
			\| Name = {{PAGENAME}}
			\| Image = Monophasic_synovial_sarcoma_-_high_mag.jpg
			\| Width =
			\| Caption = Monophasic synovial sarcoma. [[H&E stain]].
			\| Micro = one of the following (1) spindle cell sarcoma with features of hemangiopericytoma, i.e. [[staghorn vessels]]; (2) biphasic synovial sarcoma (spindle cells with features of hemangiopericytoma, epitheliod glands or nests); (3) primitive round cell type
			\| Subtypes =
			\| LMDDx = [[MPNST]], [[fibrosarcoma]], [[small round cell tumours]]
			\| Stains =
			\| IHC = Vimentin +ve, EMA +ve, BCL2 +ve, CD99 +ve.
			\| EM =
			\| Molecular = t(X;18)
			\| IF =
			\| Gross = usually lower extremity, usually close to a joint
			\| Grossing =
			\| Site = [[soft tissue lesions\|soft tissue]]
			\| Assdx =
			\| Syndromes =
			\| Clinicalhx = young adults or adolescents
			\| Signs = mass +/-pain
			\| Symptoms =
			\| Prevalence = uncommon
			\| Bloodwork =
			\| Rads =
			\| Endoscopy =
			\| Prognosis = poor
			\| Other =
			\| ClinDDx =
			}}
			'''Synovial sarcoma''', abbreviated '''SS''', is an uncommon malignant soft tissue tumour, typically seen in young adults.

			==General==
			*Does not arise from cartilage.<ref name=Ref_WMSP627>{{Ref WMSP\|627}}</ref>
			*Young adults or adolescents.
			**Classic age: 30s.
			*Poor prognosis.

			Clinical:<ref name=pmid16973781>{{Cite journal \| last1 = Murphey \| first1 = MD. \| last2 = Gibson \| first2 = MS. \| last3 = Jennings \| first3 = BT. \| last4 = Crespo-Rodríguez \| first4 = AM. \| last5 = Fanburg-Smith \| first5 = J. \| last6 = Gajewski \| first6 = DA. \| title = From the archives of the AFIP: Imaging of synovial sarcoma with radiologic-pathologic correlation. \| journal = Radiographics \| volume = 26 \| issue = 5 \| pages = 1543-65 \| month = \| year = \| doi = 10.1148/rg.265065084 \| PMID = 16973781 \| URL = http://radiographics.rsna.org/content/26/5/1543.long }}</ref>
			*Present with soft palpable mass - slow growing - often for years.
			*May present with pain.
			**Uncommon finding in sarcomas.

			==Gross==
			Location:
			*Usually close to a joint.
			*Usually distal extremity ~65% of cases.<ref name=pmid16973781/>
			**Upper extremity ~20% of cases.<ref name=pmid16973781/>

			Appearance - often non-specific:
			*Solid often lobulated +/- cystic component.
			*Grey-yellow.
			*Pushing border to ill-defined border.

			Images:
			*[http://www.sarcomaimages.com/images/db/synovial-sarcoma/synovial-sarcoma-01-gross-image,-sarcoma-images.jpg SS (sarcomaimages.com)].<ref>URL: [http://www.sarcomaimages.com/index.php?v=Synovial-Sarcoma http://www.sarcomaimages.com/index.php?v=Synovial-Sarcoma]. Accessed on: 2 April 2012.</ref>
			*[http://www.tumorlibrary.com/case/detail.jsp?image_id=2462 SS (tumorlibrary.com)].

			===Microscopic===
			Comes in three (histologic) flavours:<ref name=Ref_WMSP627>{{Ref WMSP\|627}}</ref><ref>{{cite journal \|author=Schaal CH, Navarro FC, Moraes Neto FA \|title=Primary renal sarcoma with morphologic and immunohistochemical aspects compatible with synovial sarcoma \|journal=Int Braz J Urol \|volume=30 \|issue=3 \|pages=210–3 \|year=2004 \|pmid=15689250 \|doi= \|url=http://www.brazjurol.com.br/may_june_2004/Schaal_ing_210_213.htm}}</ref>
			#Spindle cell sarcoma with features of hemangiopericytoma, i.e. [[staghorn vessels]].
			#Biphasic synovial sarcoma:
			##Spindle cells with features of hemangiopericytoma.
			##Epitheliod glands or nests.
			#Primitive round cell type.

			Features:
			*[[Herring bone]] or [[vesicular pattern]] - '''key feature'''.
			*Spindle cells.
			*+/-Glandular component - typically more pink.
			*+/-Calcification - uncommon.
			**Extensive calcification = better prognosis.<ref name=pmid6282441>{{Cite journal \| last1 = Varela-Duran \| first1 = J. \| last2 = Enzinger \| first2 = FM. \| title = Calcifying synovial sarcoma. \| journal = Cancer \| volume = 50 \| issue = 2 \| pages = 345-52 \| month = Jul \| year = 1982 \| doi = \| PMID = 6282441 }}</ref>

			DDx:
			*[[MPNST]].
			**Can be difficult.

			====Images====
			<gallery>
			Image:Monophasic_synovial_sarcoma_-_intermed_mag.jpg \| Monophasic synovial sarcoma with staghorn vessels - intermed. mag. (WC/Nephron)
			Image:Monophasic_synovial_sarcoma_-_high_mag.jpg \| Monophasic synovial sarcoma with staghorn vessels - high mag. (WC/Nephron)
			</gallery>
			www:
			*[http://www.scielo.br/img/revistas/ibju/v30n3/3a06f03.jpg Synovial sarcoma (scielo.br)].
			*[http://www.humpath.com/spip.php?page=article&id_article=1965 Synovial sarcoma - collection of images (humpath.com)].
			*[http://path.upmc.edu/cases/case292.html Synovial sarcoma - several images (upmc.edu)].
			*[http://radiographics.rsna.org/content/26/5/1543/F14.expansion.html Biphasic SS (radiographics.rsna.org)].
			*[http://radiographics.rsna.org/content/26/5/1543.long Monophasic SS (radiographics.rsna.org)].

			===IHC===
			Features:<ref name=Ref_WMSP627>{{Ref WMSP\|627}}</ref>
			*Vimentin +ve.
			*EMA +ve.
			*BCL2 +ve.
			*CD99 +ve.

			Others:
			*Beta-catenin +ve ~30-70%.<ref name=pmid16740029>{{cite journal \|author=Horvai AE, Kramer MJ, O'Donnell R \|title=Beta-catenin nuclear expression correlates with cyclin D1 expression in primary and metastatic synovial sarcoma: a tissue microarray study \|journal=Arch. Pathol. Lab. Med. \|volume=130 \|issue=6 \|pages=792–8 \|year=2006 \|month=June \|pmid=16740029 \|doi= \|url=}}</ref>
			*Cyclin D1 ~50%.<ref name=pmid16740029/><ref name=pmid15375433>{{cite journal \|author=Ng TL, Gown AM, Barry TS, ''et al.'' \|title=Nuclear beta-catenin in mesenchymal tumors \|journal=Mod. Pathol. \|volume=18 \|issue=1 \|pages=68–74 \|year=2005 \|month=January \|pmid=15375433 \|doi=10.1038/modpathol.3800272 \|url=}}</ref>
			*TLE1 +ve nuclear staining; not specific for synovial sarcoma.<ref name=pmid19363472>{{cite journal \|author=Kosemehmetoglu K, Vrana JA, Folpe AL \|title=TLE1 expression is not specific for synovial sarcoma: a whole section study of 163 soft tissue and bone neoplasms \|journal=Mod. Pathol. \|volume=22 \|issue=7 \|pages=872–8 \|year=2009 \|month=July \|pmid=19363472 \|doi=10.1038/modpathol.2009.47 \|url=http://www.nature.com/modpathol/journal/v22/n7/full/modpathol200947a.html}}</ref><ref>{{cite journal \|author=Seo SW, Lee H, Lee HI, Kim HS \|title=The role of TLE1 in synovial sarcoma \|journal=J Orthop Res \|volume= \|issue= \|pages= \|year=2011 \|month=February \|pmid=21319215 \|doi=10.1002/jor.21318 \|url=}}</ref>

			Typically negative:<ref>URL: [http://path.upmc.edu/cases/case292/dx.html http://path.upmc.edu/cases/case292/dx.html]. Accessed on: 14 January 2012.</ref>
			*CD34.
			*S100 ~30% +ve.
			*SMA.

			Notes:
			*Synovial sarcoma & MPNST:
			**Both +ve: PGP9.5 (UCHL1<ref>{{OMIM\|191342}}</ref>), S100, NGFR, CD56, CD99, vimentin.
			**Synovial +ve: EMA, keratin, BCL2, TLE1.
			**MPNST +ve: nestin, CD34.

			Trivia:
			*PGP in ''PGP9.5'' = protein gene product.<ref name=pmid6343558>{{Cite journal \| last1 = Doran \| first1 = JF. \| last2 = Jackson \| first2 = P. \| last3 = Kynoch \| first3 = PA. \| last4 = Thompson \| first4 = RJ. \| title = Isolation of PGP 9.5, a new human neurone-specific protein detected by high-resolution two-dimensional electrophoresis. \| journal = J Neurochem \| volume = 40 \| issue = 6 \| pages = 1542-7 \| month = Jun \| year = 1983 \| doi = \| PMID = 6343558 }}</ref>

			===EM===
			Features:<ref name=pmid9930576>{{Cite journal \| last1 = Fisher \| first1 = C. \| title = Synovial sarcoma. \| journal = Ann Diagn Pathol \| volume = 2 \| issue = 6 \| pages = 401-21 \| month = Dec \| year = 1998 \| doi = \| PMID = 9930576 }}</ref>
			*Biphasic tumour have biphasic ultrastructural features (unlike spindle cell carcinoma and [[epithelioid sarcoma]]).
			*Epithelioid component is adenocarcinoma-like - they have:
			**Intermediate filaments.
			**[[Tonofilament]]s.
			**Microvilli.
			*[[Spindle cell]] component - mostly features less.
			**Poorly formed desmosomes.
			**No intermediate filaments, no myofilaments.

			===Molecular pathology===
			Associated [[translocation]]:
			*t(X;18)(p11.2;q11.2).<ref>URL: [http://www.ncbi.nlm.nih.gov/omim/300813 http://www.ncbi.nlm.nih.gov/omim/300813]. Accessed on: 30 May 2010.</ref>
			**SYT/SSX fusion gene.

			Several SSX genes - cannot be differentiated with standard karyotyping:
			*SSX1.
			*SSX2 - better survival, rarely seen in biphasic tumours.<ref>{{Ref APBR\|625 Q6}}</ref>
			*SSX4 - uncommon.

			Notes:
			*At HSC t(X,18) = synovial sarcoma.

			==See also==
			*[[Soft tissue lesions]].

			==References==
			{{Reflist\|2}}

	[[Category:Diagnosis]]		[[Category:Diagnosis]]

Michael: +cat.

2011-10-20T04:41:12Z

+cat.

← Older revision		Revision as of 04:41, 20 October 2011
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	#redirect [[Soft_tissue_lesions#Synovial sarcoma]]		#redirect [[Soft_tissue_lesions#Synovial sarcoma]]

			[[Category:Diagnosis]]

Michael: redirect for now

2011-01-19T03:35:58Z

redirect for now

New page

#redirect [[Soft_tissue_lesions#Synovial sarcoma]]