case_images: PMC11788170_01
case_images: The patient's chest CT scan revealed a solid nodule (red arrow) at the apicoposterior segment of the upper left lobe of the lung, located close to the pleura, measuring approximately 1.8 x 1.2 cm. There are visible spiculated signs around the nodule, and no calcification was observed on the mediastinal window.
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case_images: cnr270104-fig-0001
case_images: At our hospital, chest CT showed an 18 mm x 12 mm solid nodule with spiculated edges in the upper left lung lobe (Figure 1).
case_images: This is the specimen resected during the surgery. It can be seen that the whole tumor was resected intact, with a size of about 1.8 cm x 1.5 cm, grayish white in color, and obvious tissue necrosis (orange arrow).
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case_images: cnr270104-fig-0002
case_images: In October 2023, thoracoscopic wedge resection of the upper lobe of the left lung was performed, and the tumor was completely removed with negative margins (Figure 2).
case_images: On this pathological slide, spindle-shaped cells with relatively consistent morphology were arranged in bundles (black arrow). Epithelial-like cells were columnar and glandularin structure, and eosinophilic secretions were visible (red numbers). The diagnosis was biphasic synovial sarcoma (HE original magnification x100).
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case_images: PMC11788170_01_CNR2-8-e70104-g002.jpg
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case_images: Postoperative pathology and immunohistochemistry further confirmed the diagnosis, with results including Desmin (-), Myogenin (-), Caldesmon (-), SMA (-), SDHB (+), Ki-67 (40%), CD99 (+), Bcl-2 (+), AE1/AE3 (+), EMA (+), Calponin (+), CD34 (vascular +), S100 (-), and CD117 (-) (Figure 3).
case_images: The nodule is close to the periphery, so wedge resection is chosen during the operation. After the operation, the CT scan shows the shadow of the stapler chain. The tumor is resected with R0 resection while maximizing the preservation of lung function. The lung expands completely after the operation, and the postoperative recovery is good.
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case_images: The postoperative recovery was good, and the chest CT showed that lung function had been maximally preserved (Figure 4).