膝关节及髌骨内色素沉着性绒毛结节性滑膜炎一例报告

Multifocal pigmented villonodular synovitis arising separately in the articular knee joint and the patella:1 case report

色素沉着性绒毛结节性滑膜炎（pigmented villonodular synovitis,PVNS）是发生于关节或腱鞘滑膜组织的少见良性肿瘤性疾病,其进展后期,病变可自关节内侵犯、破坏邻近软骨及骨组织,但是不破坏关节面,在骨内直接形成局限病灶的情况未见有报道[1-3]。我科2014年11月收治1例同时发生于膝关节和髌骨内的PVNS罕见病例。现将该病例的病史、影像学、手术、病理诊断等临床资料,

Objective To describe a rare case of pigmented villonodular synovitis（ PVNS） with a nodular lesion in the left patella, diffuse affected synovial tissue in the left knee and an extra-articular mass in the left poplitea. Methods A 37-year-old female with complaints of intermittent left knee pain（ 3 years） and a painful mass palpated in her left poplitea was analyzed. Results On plain radiograph, an osteolytic lesion was evident in the left patella, ESR： 8 mm / h, CRP： 3.1 mg / L, no obvious abnormal signals. Magnetic resonance imaging（ MRI） of left knee showed lesions with same signal intensity coexist both in the inner left patella, left intra-articular knee joint and left extraarticular poplitea. Diagnosis of PVNS was made. Combined with arthroscopic synovectomy, open resection of lesions and iliac crest bone graft for patellar bone defect were performed. The postoperative pathological diagnoses of the resected mass from the poplitea, the affected synovial tissue and the lesion in the patella were consistent with PVNS. The postoperative clinical course was uneventful. No signs of recurrence were found at 1-year follow-up. Conclusions This is the fi rst report of PVNS occurring both in the inner left patella, left intra-articular knee joint and left extraarticular poplitea.