J Korean Orthop Assoc.  1996 Apr;31(2):381-387. 10.4055/jkoa.1996.31.2.381.

A Study of 3 Cases of Synovial Sarcoma by Immunohistochemical Stain and Electron Microscopy

• Ha SH
• Lee SH
• Shin DM
• Lee MS
• Jeon HJ

• KMID: 2423619
• DOI: http://doi.org/10.4055/jkoa.1996.31.2.381

Abstract

Synovial sarcoma is a distinct and generally recognized soft tissue tumor that it's origin still raises controversy. The synovial origin of synovial sarcoma has not been determined despite the accepted terminology implying synovium as stem cell. Three cases of primary synovial sarcoma (2 fibrous monophasic, 1 biphasic type) were studied with a panel of antibodies against different types of cytokeratin and other markers (EMA, CEA, vimentin, S-100 protein, lysozyme, 1-antichymotrypsin). Spindle shaped-cell in monophasic synovial sarcoma showed reactivity for CK7 and pancytokeratin. Epithelial cells lining of glands in biphasic synovial sarcoma reactive for CK7, pancytokeratin, EMA, and focally CEA but spindle cells only positive for vimentin. By electron microscopy, fibrous monophasic synovial sarcoma showed pseudogland formation with intercellular junctions of paired subplasmalemmal destiny and discontinuous basal lamina. These results indicate that synovial sarcoma showes epithelial differentiation. We believe that synovial sarcoma arises in pluripotential connective tissue cells that is able to be differentiated into both mesenchymal and epithelial components. So, synovial sarcoma have been considered carcinosarcoma of soft tissues depending on the type of differentiation.

Keyword

Synovial sarcoma; Immunohistochemistry; Electron microscopy

MeSH Terms

Antibodies
Basement Membrane
Carcinosarcoma
Connective Tissue Cells
Epithelial Cells
Immunohistochemistry
Intercellular Junctions
Keratins
Microscopy, Electron*
Muramidase
S100 Proteins
Sarcoma, Synovial*
Stem Cells
Synovial Membrane
Vimentin
Antibodies
Keratins
Muramidase
S100 Proteins
Vimentin

Figure

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  Fig. 1 On enhanced T1-weighted image, heterogenous enhanced soft tissue mass shows multilobulated contour with internal septation at left gluteus muscle.

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  Fig. 2 On chest PA, multiple, variable sized hematogenous metastatic nodules ard scattered in the entire lung, and also noted the right pleural effusion.

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  Fig. 3-A Monophasic fibrous synovial sarcoma, Tightly apposed spindle cells reveals fibrosarcoma like pattern (H&E, x100). B. Plump spindle cells are reactive for vimentin in case 1 (ABC, x200). C. Diffusely packed fibroblastlike spindle cells reactive for pankeratin in case 2 (ABC, x100).

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  Fig. 4 Paired subplasmalemmal density(PSD, arrow) is observed between tightly packed spindle cells (Uranyl acetate and lead citrate, Original magnification x2,800).

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  Fig. 5 PSD(arrow) and discontinuous basal lamina around spindle cells are observed (Uranyl acetate and lead citrate, Original magnification x2,800).

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  Fig. 6 Spindle cells showing pseudoglandular formation are observed.(Uranyl acetate and lead citrate, Original magnification x2,800).

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