Nicholson A G, Goldstraw P, Fisher C
Department of Histopathology, Royal Brompton Hospital, London, UK.
Histopathology. 1998 Dec;33(6):508-13. doi: 10.1046/j.1365-2559.1998.00565.x.
Synovial sarcomas are rare tumours occasionally arising in the pleural cavity, a site where their histological characteristics may be mistaken for those of malignant mesothelioma. We examined three cases of primary pleural synovial sarcoma in order to look for clinicopathological features that may help in distinguishing them from both mesotheliomas and other sarcomas that may arise in the pleura.
All three patients were male, aged 42, 28 and 42, respectively, and had no known exposure to asbestos. One biphasic tumour contained neutral mucin in focal epithelial elements that also stained positively for BerEP4 and AUA1. All three tumours showed focal positivity for either keratin or EMA in the sarcomatous elements, and they also stained positively for bcl-2 protein and MIC2 gene product (CD99).
Our results emphasize the importance of being aware of synovial sarcoma as a possible primary pleural malignancy, especially in a young patient with a localized mass. In addition, the presence of bcl-2 protein perhaps represents a useful marker in distinguishing synovial sarcoma, especially monophasic variants, from mesothelioma within a panel of antibodies.
滑膜肉瘤是罕见肿瘤，偶尔发生于胸腔，在此部位其组织学特征可能被误诊为恶性间皮瘤。我们检查了3例原发性胸膜滑膜肉瘤病例，以寻找有助于将其与间皮瘤以及可能发生于胸膜的其他肉瘤相鉴别的临床病理特征。
所有3例患者均为男性，年龄分别为42岁、28岁和42岁，均无已知石棉接触史。1例双相肿瘤在局灶性上皮成分中含有中性黏液，且这些上皮成分对BerEP4和AUA1呈阳性染色。所有3例肿瘤在肉瘤成分中对角蛋白或EMA呈局灶性阳性，并且它们对bcl-2蛋白和MIC2基因产物（CD99）也呈阳性染色。
我们的结果强调了认识到滑膜肉瘤作为一种可能的原发性胸膜恶性肿瘤的重要性，特别是对于患有局限性肿块的年轻患者。此外，bcl-2蛋白的存在可能是在一组抗体中区分滑膜肉瘤，尤其是单相变异型，与间皮瘤的有用标志物。
