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Soft Tissue Tumors
Lipoma arborescens
Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Reviewer: David Lucas, M.D., University of Michigan Health Systems (January 2009)
Revised: 26 June 2009, last major update June 2009
Definition
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● Fatty infiltration of subsynovial connective tissue in a large joint; rarely affects synovial sheaths of tendons (J Am Podiatr Med Assoc 2009;99:153)
Terminology
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● Also called villous lipomatous proliferation of synovial membrane, diffuse lipoma of joint
● Not a WHO diagnosis
Epidemiology
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● Rare; older patients, usually male, associated with joint trauma, degenerative joint disease and chronic arthritis
Clinical
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● Usually knee
● May be a reactive process
● MRI is useful in diagnosis (Radiol Med (Torino) 2005;109:540)
Case reports
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● Bilateral knee involvement (Knee 2005;12:394)
● Multifocal (Skeletal Radiol 2005;34:536)
Treatment and prognosis
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● Synovectomy; may recur since often is a reactive process
Gross description
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● Yellow fat in villous fronds
Gross images
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Villous architecture of synovium (fig 2)
Micro description
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● Hypertrophic villous projections of fat lined by synovial cells, variable scattered inflammatory cells
Micro images
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Hypertrophied synovial tissue with Synovial tissue replaced by
synovial lining cells, containing adipose (figure 2C)
adipose tissue
Various images (fig 3-4) Various images
Additional references
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End of Soft Tissue Tumors > Lipoma arborescens
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