Shih W J, Banks E R, Purcell M, Nicholls P
Nuclear Medicine Service, Department of Veterans Affairs Medical Center, Lexington, KY, USA.
Arch Orthop Trauma Surg. 1997;116(3):181-3. doi: 10.1007/BF00426069.
A 61-year-old man with a slow-growing, painless mass in the area of the right knee underwent radiographic, computed tomographic (CT), arthrographic, arteriographic, and bone scintigraphic imaging studies. Scintigraphy showed an area of intense uptake in the anterolateral part of the knee; the uptake of the knee was much higher than that of the knee joints, but the area was not connected to the joint. Radiographic findings suggested an osteocartilaginous mass which was seen to contain low-density fatty tissue on the CT exam. Arthrography revealed that there was no connection of the mass to the knee joint. Arteriography showed a mildly vascularized tumor mass. Upon removal, the mass was well encapsulated, measuring 10 x 7 x 7 cm, and consisted of integrated nodules of bone, cartilage, and fat tissue. Microscopic examination confirmed lipoma with osteochondromatous metaplasia. The intense uptake in the lipoma near the bone or joint on the bone scan and multiple osteochondromatous nodules shown on CT may serve as characteristic features of the rare chondrosseous metaplasia within a lipoma.
一名61岁男性，右膝部位有一个生长缓慢、无痛性肿块，接受了X线、计算机断层扫描（CT）、关节造影、动脉造影和骨闪烁成像检查。闪烁扫描显示膝关节前外侧有一个摄取增强区域；膝关节的摄取明显高于其他膝关节，但该区域与关节不相连。X线检查结果提示为骨软骨瘤样肿块，CT检查显示其中含有低密度脂肪组织。关节造影显示肿块与膝关节无连接。动脉造影显示肿瘤肿块血供轻度丰富。切除的肿块包膜完整，大小为10×7×7 cm，由骨、软骨和脂肪组织的融合结节组成。显微镜检查证实为伴有骨软骨化生的脂肪瘤。骨扫描时脂肪瘤在骨或关节附近的摄取增强以及CT显示的多个骨软骨瘤样结节可能是脂肪瘤内罕见的软骨化生的特征性表现。
