Which imaging findings are characteristic of pleural synovial sarcoma?

Updated: Dec 25, 2019
  • Author: Joseph F Tomashefski, Jr, MD; more...
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On standard chest radiographs, synovial sarcoma appears as a homogeneous pleural-based mass with sharply marginated borders and round, ovoid, or lobulated contours. [37] In some cases, greater than 50% of the hemithorax is opacified. On CT scans, most pleuropulmonary tumors appeared to be pleural based. However, localization to either lung or pleura is sometimes difficult radiographically.

In most cases, the mass shows heterogeneous enhancement with nodular soft-tissue components mixed with areas of low attenuation and occasional septa. An enhanced peripheral rim is present in many cases. Often, an ipsilateral pleural effusion is an associated finding. MRI provides an excellent demonstration of the nodular soft-tissue component and multilocular fluid-filled internal compartments, as well as peripheral rim enhancement after the intravenous administration of gadolinium-based contrast material. [37]

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