A rare case of an intra-articular true lipoma of the ankle.

BACKGROUND: Most of the foot and ankle soft tissue tumors are benign. Although lipomas are the most common soft tissue tumors, intra-articular lipomas are an extremely rare entity. The majority of described cases of intra-articular lipomas occur in the knee joint. In particular, an intra-articular true lipoma of the ankle has not been reported. CASE PRESENTATION: We report the case of a 45-year-old woman who presented with a progressively growing ankle mass over 5 years, which started to restrict the range of motion. It was not preceded by any trauma or sports activity. On examination, a non-tender firm mass was evident on the lateral aspect of the right ankle joint with no signs of inflammation. It was non-compressible, non-mobile, and did not transilluminate. The clinical diagnosis was probable for a soft tissue ganglion. A radiograph revealed a soft tissue opacity over the anterolateral aspect of the tibiotalar joint. Magnetic resonance imaging (MRI) demonstrated a well-defined, multilobulated, encapsulated lesion located at the lateral aspect of the tibiotalar joint; with intra- and extra-articular components and an analogous signal intensity to fat. The patient underwent surgical excision of the tumor, and the histopathological examination showed mature adipose tissue representing an intra-articular lipoma. At the follow-up visit, the patient had complete resolution of symptoms and no active complaints. CONCLUSION: An intra-articular true lipoma of the ankle is an extremely rare tumor. MRI is an invaluable diagnostic tool to make a reliable diagnosis of intra-articular masses.

Spectrum of lymphoma in Bahrain. A retrospective analysis according to the World Health Organization classification.

OBJECTIVES: To determine the spectrum of various types of lymphoma in Bahrain according to the latest World Health Organization classification criteria.  Methods: A retrospective review was conducted for all new lymphoma cases diagnosed at Salmaniya Medical Complex, Manama, Bahrain during the period from January 2010 to December 2015.  Results: Two hundred and twenty-one new cases of lymphoma in Bahraini patients were diagnosed in the study period. Eighty patients had Hodgkin lymphoma, 140 had non-Hodgkin lymphoma, and one patient had composite lymphoma. In the Hodgkin lymphoma group, nodular sclerosis type was the most frequent type (48.75%), followed by mixed-cellularity type (27.5%), and nodular-lymphocyte predominant type (16.25%). In the non-Hodgkin lymphoma group, 124 (88.6%) cases were B-cell lymphomas, while the remaining were T-cell lymphomas. Diffuse large B-cell lymphoma was the most frequent type of non-Hodgkin B-cell type lymphoma (55.7%), followed by follicular lymphoma (10%).  Conclusion: The distribution of lymphoma in Bahrain is similar to neighboring Middle East countries with a predominance of Hodgkin lymphoma and diffuse large B-cell lymphoma.