고관절에 발생한 수목상 지방종의 MRI소견: 증례 보고

MRI Findings of Synovial Lipoma Arborescens of the Hip: A Case Report

  • 박희진 (관동대학교 의과대학 명지병원 영상의학과) ;
  • 박성일 (연세대학교 의과대학 신촌세브란스병원 영상의학과) ;
  • 박찬섭 (관동대학교 의과대학 명지병원 영상의학과) ;
  • 김미성 (관동대학교 의과대학 명지병원 영상의학과) ;
  • 박노혁 (관동대학교 의과대학 명지병원 영상의학과) ;
  • 박재형 (관동대학교 의과대학 명지병원 정형외과) ;
  • 이상엽 (관동대학교 의과대학 명지병원 병리과)
  • Park, Hee-Jin (Department of Radiology, Myoungji Hospital, Kwandong University College of Medicine) ;
  • Park, Sung-Il (Department of Radiology, Shinchon Severance Hospital, Yonsei University School of Medicine) ;
  • Park, Chan-Sub (Department of Radiology, Myoungji Hospital, Kwandong University College of Medicine) ;
  • Kim, Mi-Sung (Department of Radiology, Myoungji Hospital, Kwandong University College of Medicine) ;
  • Park, Noh-Hyuck (Department of Radiology, Myoungji Hospital, Kwandong University College of Medicine) ;
  • Park, Jai-Hyung (Department of Orthopedic Surgery, Myoungji Hospital, Kwandong University College of Medicine) ;
  • Yi, Sang-Yeop (Department of Pathology, Myoungji Hospital, Kwandong University College of Medicine)
  • 투고 : 2010.03.23
  • 심사 : 2010.08.21
  • 발행 : 2010.12.01

초록

수목상지방종은 활액막의 융모성 지방 증식을 동반한 드문 관절 내 병변으로 슬관절 주위, 특히 상슬개골와에 생기는 경향이 있다. 이 병변은 다른 부위, 예컨대 견관절, 삼각근하낭, 고관절 그리고 주관절 등에서도 관찰될 수 있으나 매우 드문 편이다. 우리는 34세 남자환자에서 편측으로 발생한 수목상지방종 증례를 보고한다. MRI와 전신 골주사검사가 시행되었고 수술적 활액막 제거가 이루어졌다. 병리조직학적 검사에서 수목상지방종으로 진단되었다.

Lipoma arborescens is a rare intra-articular lesion consisting of villous lipomatous proliferation of the synovium that tends to occur in the knee joint, especially in the suprapatellar pouch. The lesion has been observed in other locations, including the glenohumeral joint, subdeltoid bursa, hip, and elbow. We report a case of a lipoma arborescens of a unilateral hip joint in a 34-year-old man. MRI and a whole body bone scan were performed. In addition, a surgical synovectomy was performed and microscopic examination of the tumor revealed multiple variable-sized villous masses composed of mature fat tissue and lined by synovial cells which confirmed the diagnosis of lipoma arborescens.

키워드

참고문헌

  1. Feller JF, Rishi M, Hughes EC. Lipoma arborescens of the knee: MR demonstration. AJR Am J Roentgenol 1994;163:162-164 https://doi.org/10.2214/ajr.163.1.8010204
  2. Ryu KN, Jaovisidha S, Schweitzer M, Motta AO, Resnick D. MR imaging of lipoma arborescens of the knee joint. AJR Am J Roentgenol 1996;176:1229-1232
  3. Bejia I, Younes M, Moussa A, Said M, Touzi M, Bergaoui N. Lipoma arborescens affecting multiple joints. Skeletal Radiol 2005;34:536-538 https://doi.org/10.1007/s00256-005-0900-4
  4. Wolf RS, Zoys GN, Saldivar VA, Williams RP. Lipoma arborescens of the hip. Am J Orthop 2002;31:276-279
  5. Noel ER, Tebib JG, Dumontet C, ColsonF, Carret JP, Vauzelle JL, et al. Synovial lipoma arborescens of the hip. Clin Rheumatol 1987;6:92-96 https://doi.org/10.1007/BF02201009
  6. Martin S, Hernandez L, Romero J, Lafuente J, Poza AI, Ruiz P, et al. Diagnostic imaging of lipoma arborescens. Skeletal Radiol 1998; 27:325-329 https://doi.org/10.1007/s002560050390
  7. Sola JB, Wright RW. Arthroscopic treatment for lipoma arborescens of the knee. J Bone Joint Surg Am 1998;80:99-103 https://doi.org/10.2106/00004623-199801000-00017
  8. Edamitsu S, Mizuta H, Kubota K, Matsukawa A. Lipoma arborescens with hemarthrosis of the knee: a case report. Acta Orthop Scand 1993;64:601-602 https://doi.org/10.3109/17453679308993704
  9. Yan CH, Wong JW, Yip DK. Bilateral knee lipoma arborescens: a case report. J Orthop Surg 2008;16:107-110 https://doi.org/10.1177/230949900801600125
  10. Hallel T, Lew S, Bansal M. Villous lipomatous proliferation of the synovial membrane (lipoma arborescens). J Bone Joint Surg Am 1988;70:264-270 https://doi.org/10.2106/00004623-198870020-00016