General
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• Also called Hoffa's disease, villous lipomatous proliferation of synovium, lipoma arborescens
• Pseudotumor of synovium with distinct histomorphology, possibly due to inappropriate fat deposition and degenerative articular diseases of joints (J Lab Physicians 2011;3:84)

Clinical features
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• Rare; usually knee but may occur in any joint
• Unknown etiology
• Males commonly affected with pain and swelling of joint

Treatment
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• Arthroscopy and excision

Gross description
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• Enlargement of infrapatellar fat pad with pain in anterior compartment of knee; synovium is papillary, yellow and fatty

Micro description
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• Synovial hyperplasia with unremarkable fat extending to synovial lining; occasional chronic inflammatory infiltrate

Micro images
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Villi-like structures

Papillary architecture

Mature adipocytes

Focal hyperplasia

Few mature lipocytes

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