Radiation-Induced Synovial Sarcoma of the Lung Diagnosed by Gene Analysis after the Surgical Resection of Chondrosarcoma Arising from the Scapula
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- Kubouchi Yasuaki
- Division of General Thoracic Surgery, Tottori University Hospital, Yonago, Tottori, Japan
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- Taniguchi Yuji
- Division of General Thoracic Surgery, Tottori University Hospital, Yonago, Tottori, Japan
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- Matsuoka Yuki
- Division of General Thoracic Surgery, Tottori University Hospital, Yonago, Tottori, Japan
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- Haruki Tomohiro
- Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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- Fujioka Shinji
- Division of General Thoracic Surgery, Tottori University Hospital, Yonago, Tottori, Japan
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- Miwa Ken
- Division of General Thoracic Surgery, Tottori University Hospital, Yonago, Tottori, Japan
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- Nakamura Hiroshige
- Division of General Thoracic Surgery, Tottori University Hospital, Yonago, Tottori, Japan
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抄録
The patient was a 62-year-old male who underwent wide resection and radiotherapy for right scapular chondrosarcoma 12 years ago. An abnormal shadow was detected in the right upper lung field included in the irradiated field on chest X-ray. Since the nodule tended to enlarge, a malignant lung tumor was suspected, and surgery was performed. On histological examination, spindle cells densely proliferated in a bundle pattern. Vimentin, bcl-2 protein, and CD99 were positive, and CD34, cytokeratin, AE1/AE3, and EMA were partially positive on immunohistochemical staining. The SYT-SSX (synaptotagmin- synovial sarcoma X) fusion gene was detected employing RT-PCR, based on which primary synovial sarcoma of the lung was diagnosed. The findings also matched the diagnostic criteria of radiation-induced sarcoma, suggesting radiation-induced primary synovial sarcoma of the lung. Primary synovial sarcoma of the lung is a rare tumor. It is difficult to diagnose based on cellular findings, and immunohistochemical and genetic investigations are essential. Radiation-induced sarcoma may develop through a long-term course, as seen in this patient, for which long-term follow-up after radiotherapy is important.
収録刊行物
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- Annals of Thoracic and Cardiovascular Surgery
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Annals of Thoracic and Cardiovascular Surgery 19 (2), 144-147, 2013
Annals of Thoracic and Cardiovascular Surgery 編集委員会