Ambreen Moatasim, Anwarul Haque.
Monophasic synovial sarcoma diagnosed on FNAC.
Int J Pathol Jan ;2(2):109-11.

A 52 year old male presented with a large painful swelling on the anterolateral aspect of proximal right leg approximately 12 cm in diameter. The swelling was progressively increasing in size and was associated with off and on fever. On examination it was a large non specific, somewhat lobulated swelling. It was tender, mobile, fluctuant with no restriction of knee movements. His base line investigations were within normal limits. Chest X-ray, CT chest and ECG were normal. MRI of the right leg suggested a sarcomatous lesion. Bone scan revealed increased uptake. Fine needle aspiration cytology and subsequently, a core needle biopsy was performed. Cytologic Findings: Atypical spindle shaped plump cells were present scattered as well as in cohesive clusters. These atypical cells had pleomorphic, hyperchromatic nuclei with irregular chromatin clearing and nuclear indentations. The cytoplasm was eosinophilic and relatively ample. Histopathological Findings: The microscopic examination of the core needle biopsy specimen revealed a malignant mesenchymal neoplasm in which the malignant cells were arranged in solid compact sheets. These cells were spindle shaped with pleomorphic, hyperchromatic nuclei having prominent nucleoli and irregular chromatin clearing. The cytoplasm was plump and relatively ample. The N/C ratio was nonetheless higher than reactive Synovial cells. The picture conformed with the cytopathological findings. There were 3 mitoses per high power field. On the basis of these features, a diagnosis of Monophasic Synovial Sarcoma was made.

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