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. 2016:2:28.
doi: 10.1051/sicotj/2016019. Epub 2016 Jul 6.

Lipoma arborescens arising in the extra-articular bursa of the knee joint

Shinji Minami  1 , Yusuke Miyake  2 , Hirofumi Kinoshita  1
Affiliations

Lipoma arborescens arising in the extra-articular bursa of the knee joint

Shinji Minami et al. SICOT J. 2016.

Abstract

Lipoma arborescens arising in the extra-articular bursa of the knee joint is extremely rare. We describe an 11-year-old boy who complained of a gradual swelling mass of the lateral knee joint. Magnetic resonance imaging (MRI) showed a high signal intensity tumor on T1- and T2-weighted images with a thickened septa and nodular lesion that showed low signal intensity. The radiologist suggested the possible differential diagnosis of well-differentiated liposarcoma. At operation, the tumor was found under the iliotibial tract and was not in contact with the knee joint. Histopathologically, this lesion was diagnosed as lipoma arborescens arising in the extra-articular bursa of the knee joint. On MRI, the appearance of lipoma arborescens arising in the extra-articular bursa of the knee joint differed from that of conventional intra-articular lipoma arborescens. In this report, we describe a case of extra-articular lipoma arborescens of the knee joint bursa and discuss the diagnosis and etiology.

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Figures

Figure 1.
Figure 1.
Plain radiographs of the knee joint did not show calcified and osseous lesions.
Figure 2.
Figure 2.
MRI of the tumor demonstrated a high signal intensity area on the T1-weighted image in the axial (a) and T2-weighted image in the axial and coronal views (b, c), and heterogeneously, a low signal intensity area was seen in the tumor. The tumor was located in the extra-capsular lesion of the lateral knee joint and had a diameter of 4 cm.
Figure 3.
Figure 3.
Resection of the tumor. The tumor was a yellow soft mass with a thin capsule. The tumor was found under the iliotibial tract and was not in contact with the knee joint.
Figure 4.
Figure 4.
Histopathological examination of excised tumor. (a) Synovial tissue was detected in the margin of this tumor (*). In the subsynovia, there was a thick fibrous septum and diffuse proliferation of fat tissue (Hematoxylin and eosin, × 20). (b) Diffuse proliferation of fat tissue was also detected in the tumor and atypical lipoblasts were not seen (Hematoxylin and eosin, × 50). (c) A few chondral nodules and a thick fibrous septa were found in the fat tissue (Hematoxylin and eosin, × 10).
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