PMC4376929_01
Computed tomography, portal venous phase: tumor of about 5cm in diameter filling out the right pyelon and showing slow contrast enhancement.
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F1
There was no evidence of metastases (fig. 1).
a Typical fascicles of mitotically active spindle-shaped cells of monophasic synovial sarcoma. b Tumor cells invading into a blood vessel lumen.
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F2
There was prominent mitotic activity and a microscopic vascular invasion (fig. 2).
FISH-testing revealing SYT gene rearrangement: some cells show a normal signal with yellow fusion signals (orange arrow), reflecting nonrearranged alleles. The majority of cells, however, show a pathological signal pattern with separated orange and green signals (green arrows) indicative of a rearrangement.
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F3
A definitive diagnosis was achieved by the confirmation of a SYT gene rearrangement using a SYT dual color break apart probe-based (Z-2097-50; Zytovision, Bremerhaven, Germany) FISH test (fig. 3).