CTICasesPrimary Pulmonary Synovial Sarcoma with Pleural Rupture
Imaging findings
A 24-year-old female presented with chest pain and a large, heterogeneous, well-circumscribed mass in the left upper lobe, appearing to arise from the lung parenchyma on MR. The mass showed peripheral enhancement with later central fill-in. Acute symptoms led to a non-contrast CT, which revealed the mass involving the upper lobe bronchus. The mass subsequently ruptured into the pleura, with contained clot and free fluid, necessitating an extrapleural lobectomy.
Key takeaways
Primary pulmonary synovial sarcoma is an exceedingly rare malignancy that can arise from the lung parenchyma or pleura. Its rapid growth and potential for acute rupture into the pleural space highlight its aggressive nature. Imaging characteristics may initially suggest other tumors, but biopsy is definitive. These tumors can grow very quickly.
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