Another type of sarcoma that may involve the lungs is called the Synovial sarcoma. This type occurs predominantly in the extremities, in the areas of large joints where it tends to arise in the vicinity of large joints, specifically the knee region. This type of sarcoma can also occur in the head and neck, chest and abdominal wall (Enzinger, F. M & S. W. Weiss 1995). World Health Organization classifies Synovial Sarcoma as miscellaneous soft tissue tumors (Weiss, SW 1994). Synovial Sarcoma, although very rare, also arise in the lungs (Japanese Journal of Clinical Oncology, 2001).
Using a diagnosis method called reverse transcription polymerase chain reaction (RT-PCR), researchers were able to document this rare care in a 49-year old woman referred to a hospital. In the case report made by Hiroshi Terasaki and colleagues, initial symptom exhibited by the patient was just a slight productive cough. When a routine chest radiograph was done to the patient, she was found to have an abnormal opacity in her left middle lung. A chest CT scan also revealed an oval-shaped mass in the left upper lobe of the lung measuring 5×4 cm.
The mass appeared to be encapsulated by a fibrous tissue which forced the adjacent tissues to compress on the cut surface. When the image was magnified, the tumor appears to be a dense proliferation of spindle cell with a distinct cytoplasm. The sarcoma appears as yellow or whitish. Figure 1. H. Terasaki, et. al (2001) Journal of Clinical Oncology Figure 1 was adapted by this writer from the cases study report made by Terasaki and colleagues, published in the Journal of Clinical Oncology, 2001, Volume 31, page 213. The figure shows clearly the oval-shaped mass in the left upper lobe of the lungs.
Figure 2. Magnified view of the tumor with the spindle cells and the distinct cytoplasm Figure 3. The cut section of the mass found in the lungs Metastatic sarcoma is a type that occurs in the lungs on all sarcomas that spread outside their local area of origin. It is usually characterized by a multifocal lesions scattered through the periphery of the lung that maybe found frequent in the lower lobes where the supply of blood is richer. The nodules of this type appear to be fleshy, glassy, cartilaginous or bony (Sanders, Melinda, 1994).
REFERENCES
Enzinger FM, Weiss SW. Soft Tissue Tumors, 3rd ed. Mosby Year Book, Inc. , St Louis 1995;757–86. Jansen, J. P. et. al (1994), Primary sarcoma of the lung: a clinical study with long-term follow-up, Annals of Thoracic Surgery, Vol 58, 1151-1155 Leiomyosarcoma (LMS), viewed 23 August 2007 <http://www. cancerbackup. org. uk/Cancertype/Softtissuesarcomas/Types/Leiomy>osarcoma Sanders, Melinda (1994), Metastatic Sarcoma, Viewed 23 August 2007 <http://esynopsis. uchc. edu/S106. htm > Terasaki, Hiroshi et.al (2001),
Primary Synovial Sarcoma of the Lung: a Case Report Confirmed by Molecular Detection of SYT-SSX Fusion Gene Transcripts, Japanese Journal of Clinical Oncology 31:212-216 Schwannoma that keeps coming back, Viewed 23 August 2007, <http://www. cancerhelp. org. uk/help/default. asp? page=6215> Staddon, Athur P. et. al (2002), Osteogenic Sarcoma Presenting with Lung Metastasis, The Oncologist, Vol. 7, No. 2, 144-153, April 2002 Weiss SW. Histological Typing of Soft Tissue Tumours. International Histological Classification of Tumours, 2nd ed. Berlin: World Health Organization 1994.