Cytodiagnosis of biphasic synovial sarcoma of anterior chest wall: A rare case report

Synovial sarcoma (SS) is a rare malignant neoplasm comprising 8% of mesenchymal tumors. Only few reports defining cytological findings in SS of anterior chest wall have been described in the literature. We hereby report a case of biphasic SS of anterior chest wall, which was diagnosed on fine-needle aspiration. Cytological smears revealed bimodal cell population comprising of spindle cells and epithelial cells. Spindle cells were arranged in dense clusters, having elongated nuclei, fine nuclear chromatin and scanty cytoplasm. Epithelial cells were arranged in a glandular pattern, with central to eccentric, round nuclei, fine nuclear chromatin and scanty cytoplasm. A possibility of biphasic SS was suggested, which was later confirmed on histopathology and immunohistochemistry. Prompt diagnosis and aggressive surgical resection is mandatory for primary SS of the chest wall because of its aggressive behavior.