대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Diagnosis

Ewing Sarcoma (classical)

Radiologic Findings

Fig 1A. Mass like opacity in right lower lung zone on chest PA
Fig 1B-E Well defined, ovoid shaped, and relatively homogeneous density mass (4.1 x 2.7 cm), based on the chest wall, right lower hemithorax. The mass shows obtuse angle with chest wall, suggesting extrapulmonary mass and there was no evidence of rib erosion .

The chest wall mass was diagnosed with classical Ewing sarcoma after biopsy.

Immunohistochemical staining results: CD99 (+, strongly membranous stain), Chromogranin (+), Synaptophysin (+), CD56 (+), NSE(-), CK (-), MyoD1 (-), Desmin (-), Alpha-SMA (-), LCA (-) on the tumor cells

Brief Review

Extraskeletal Ewing sarcoma involving the chest wall
[1] Askin tumor :extraskeletal Ewing sarcoma involving the chest wall, develop from embryonal migrating cells of the neural crest, large tumor involving the chest wall and pleura
[2] Karyotype abnormality with translocation involving chromosomes 11 and 22
[3] Histology :crowded sheets of small round blue cells

Radiographic Findings
Large, unilateral, extrapulmonary mass
Difficult to determine if mass originates from chest wall or pleura
Solid, compressing adjacent lung
With or without rib destruction (25-63%)
Rapid growth
Lymphadenopathy
Pleural effusion, frequent
Lung and bone metastases
Calcification, rare

Please refer to

Case 202, Case 354,

References

Murphey MD et al. From the Radiologic Pathology Archives: Ewing Sarcoma Family of Tumors: Radiologic-Pathologic Correlation. RadioGraphics 2013; 33:803–831

Keywords

Chest wall, Malignant tumor,