Vagina, Biphasic synovial sarcoma, H&E stain [LMP77437]

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Image Details
Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Neoplasia
Diagnosis: 
Biphasic synovial sarcoma
Species: 
Human
Organ System: 
Female Genital Tract
Gender: 
Female
Age: 
40 years
Slide Contributor Information
Radi, R., Chang, M.

Keywords

vagina, synovial sarcoma

Clinical History

40 year-old female with vaginal mass.

Clinical Discussion

Synovial sarcoma is a malignant neoplasm of uncertain differentiation, most commonly characterized by a fusion gene associated with a translocation of chromosomes 18 and X. The slide shows a submucosal biphasic tumor composed of loose hypocellular areas alternating with hypercellular areas of spindle cells. Another component of benign-appearing epithelial cells forming glands and papillary projections is also present. Mitotic count is 19/10 HPF. The differential diagnosis in this case includes mullerian adenosarcoma, endometrial stromal sarcoma with epithelial component, and biphasic synovial sarcoma. The Illumina RNA Fusion panel analysis showed a translocation for the SS18-SSX1 genes, confirming the diagnosis of synovial sarcoma in this setting.