SYNOVIAL LIPOMATOSIS IN LONG STANDING OSTEOARTHRITIS: CASE REPORT

Faten Limaiem* and Saâdia Bouraoui

ABSTRACT

Synovial lipomatosis is an uncommon lesion of the synovium, that often affects the knee joint, resulting in swelling, joint pain, and effusion. The etiology of this condition remains unknown. A 68-year-old obese female patient, with a past medical history of hypertension, presented with a five-year history of chronic swelling with recent onset of mechanical symptoms while performing daily activities. Knee MRI demonstrated effusion in the suprapatellar bursa and hypertrophic synovium in the left knee with leaf-like projections of tissue, which had the same signal intensity as fat. The patient was planned for knee arthroplasty due to progression of the disease, pain and disability. Intraoperatively a yellowish, fatty, soft tissue measuring 8× 6 × 3 cm was excised from the left knee joint. It had multiple papillomatous projections on the surface. Histological examination showed multiple fingers like projections lined by hyperplastic synovium and the synovium was infiltrated by abundant benign adipose tissue. Synovial tissue also showed moderate degree of infiltration by lymphoplasmacytic cells. The final pathological diagnosis was lipoma arborescens. Post-operative recovery was uneventful.

Keywords: Lipoma arborescens, villous lipomatous proliferation, synovial membrane, pathology.