 |
| Figure 1. CT scan with arrow pointing to the mass filling the left parapharyngeal space. |
Irving Dardick
Department of Laboratory Medicine and Pathobiology
University of Toronto, Toronto, Canada
History:
A 74-year-old woman was admitted to hospital for treatment of
a pulmonary embolus. During her physical examination, an asymptomatic
mass was noted in her left pharynx and this was confirmed by CT
scan (Fig. 1). Following her recovery from the pulmonary embolus,
the mass was biopsied through the pharynx.
|
|
| Figure 1. CT scan with arrow pointing to the mass filling the left parapharyngeal space. |
Histology:
Based on the cellularity of the tumor (Fig. 2) and the results
of immunostaining for cytokeratins (Fig. 3) and vimentin (Fig.
4), which showed glandular elements surrounded by stromal-like
tumor cells, the tumor was diagnosed as a biphasic synovial sarcoma.
Radical surgery was scheduled.
|
|
| Figure 2. Biopsy of parapharyngeal mass. Cellular tumor with multiple lumens scattered among a background of closely associated small tumor cells. | Figure 3. Biopsy of tumor immunostained for high molecular weight cytokeratins. The many lumens are outlined by the strongly staining epithelial cells. Surrounding nonluminal cells are negative. |
|
| Figure 4. Biopsy of tumor immunostained for vimentin. The many nonluminal cells are strongly positive and luminal cells are at best weakly positive. |
Electron microscopy was done as part of this investigation.
