Received April 25, 2016; Accepted May 10, 2016; Published May 18, 2016
Citation: Chi-Min S, Hwei-Fan S, Ming-Tse C (2016) A Case of Coccygeal Bursitis Mimicking Subcutaneous Acute Inflammatory Lesion. J Cytol Histol 7:i101. doi:10.4172/2157-7099.1000i101
Copyright: © 2016 Shih CM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Bursa is an encapsulated structure with little lubrication fluid content, as a cushion between bony prominence and tendon, muscle or skin. Bursitis like a painful cystic mass with fluid accumulation in the synovial bursa may occur near joints.
Herein, we present a 31 year old man complaining of a painful mass on lower midline buttock for several days. He has the past history of falling down on his buttock that is on his coccyx bone, one and a half years ago. Since then, a small painless mass developed on coccygeal region. In recent days, the mass grows larger and painful. On physical examination, a 3 × 2 cm subcutaneous mass is palpable over coccygeal region without skin fistula or erythematous change.
Microscopically, skin dermis and epidermis are not affected by underlying lesion (Figures 1 and 2).
The pathologic findings are irregular cystic spaces surrounded by edematous fibrous wall over subcutaneous region (Figure 3).
Figure 3: (A and B) Low power view shows edematous bursal wall and proliferation of small blood vessels over inner wall. (A: H&E, 100X, B: Trichrome stain, 50X) (C) High power view exhibits edematous collagenous outer wall and proliferation of small blood vessels over inner wall without marked inflammatory infiltrate (Trichrome stain, 200X).
Some proliferative small blood vessels (Figure 3) and some nonspecific chronic inflammatory infiltrates with focally a few neutrophils over inner wall (Figure 4).
Fibrinous material (trichrome staining red, and PAS: +) without inflammatory infiltrate over focal inner cavity wall (Figure 5) is identified. Accordingly, bursitis with acute exacerbation or rupture is diagnosed.