| [Objective] In this passage we collected24cases of synovial sarcoma confirmed by surgery and pathology in the Third Affiliated Hospital of Jilin University from1998to2012, and centralized access to a large number of relevant literature, summarized the epidemiology of synovial sarcoma, imaging diagnosis, pathology treatment, prognosis, and other content which are related to synovial sarcoma to come up with a more scientific way of correctly diagnosis synovial sarcoma.[Methods] The statistics are collected from1998to2012in our hospital diagnosed as synovial sarcoma patients. According to the individual situation of those patients, We selected the appropriate imaging diagnostic methods (mostly including X-ray, CT, MRI). The gender of the patients, ages of onset, location of the tumor, clinical and pathological features, size of the tumor, treatment we choose and death are retrospectively analyzed in this passage.[Results] Articles collected24cases of synovial sarcoma surgical cases from1998-2012which is14years in all including14cases of male patients,10cases of female patients, the male to female ratio was1.4:1, the number of male patients are more than that of female which is right according to the articles we checked. Peak age of this synovial sarcoma is between36and63, a total of17cases, accounting for70.83%of the total number. Synovial sarcoma is easier to be found on the parts including the limbs, joints. We collected five cases from the ankle, two cases of sacroiliac joint, two cases of the knees, One case next to the right femoral shaft, wrist, hip, we found the tumor happened in the lower part of the body are extremity more than that from the upper limbs. The sizes of the rumors are mostly between3to21 centimeters.more are found of5centimeters. Skin color is usually normal. Three cases of skin redness and local venous engorgement are seen in the tumor significantly. The majority of X-ray performed of soft tissue mass in some area, The performance of the osteolytic are large mass, with the image of patchy, moth-eaten-like or sieve-like which are used as the standard of tumor violation of the bone tissue. CT images showed low density shadow such as round or lobulated mass in the organization, and there has been large block of soft tissue density shadow.Their boundaries are not clear between the muscles around the location of the tumor. The maximum diameter of the tumor is in the range of2.10-18.60centimeters, there are7patients with the size less than5centimeters and5patients with the size more than5centimeters. The MRI images, showed low frequency signal or a little lower frequency signal, heterogeneous high signal on the T2WI, there are10cases (61.11%) of all high, medium and low triple signal sign.The location of the tumor ranges from2.40to20.10centimeters, T1WI showed low-frequency signals in which you can see the shadow of the a even lower signal. The pathological manifestations of the tumor boundary is relatively clear with no capsules. Under a higher magnification we can see the tumor was composed of spindle-shaped, round shape or oval cells. The tumor was solid arranged. The nuclear of the cell is spindle-shaped, round or oval, with pale staining of chromatin and less cytoplasm. The fission phases are from5to10/10HPF. Some of the areas are of rich-cell and the spared areas are mixed with a lower density of cells In the low-density space where we can see the focal hemorrhage are mucus-like images and in some areas we can also see necrosis.[conclusion] To sum up, synovial sarcoma male patients more than female patients with patients, age of onset concentrated in young and middle-aged. Synovial sarcoma occurs more often in the large joints of limbs around to lower limb happen most common, the most common parts of the knee joint, and focus on around tendon sheath, synovial capsule, the joint capsule close relationship. Usually in clinical histology is divided into four types:single fiber type, bipolar, single phase epithelial type, low differentiated type. X-ray features:focal areas of calcification, in the joints with soft tissue mass, appeared in mass with partial nature of calcification, adjacent bone defect. CT for smaller bump or happened in more complex calcification or bone destruction display more clearly, enhance scan helps to identify the lesions composition. MRI features: in T2WI, imaging a belt between low signal interval, tumor with high performance for the signal of the mixed signals give priority to, can appear triple mixed signal as liquid similar high signal, and fat signals similar or slightly high school, and the signals of fibrous tissue... |
PDF Full Text Request