PMC4899987_01
49-year-old male with cystic adventitial disease. Postcontrast coronal MIP image from lower-extremity contrast-enhanced MR angiography demonstrates focal "hourglass" narrowing of the right popliteal artery (arrow). The remaining vasculature is normal.
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While the left side was normal, the right popliteal artery showed a focal narrowing with "hourglass" extrinsic impression (Fig. 1).
49-year-old male with cystic adventitial disease. T2-weighted MR. A. Sagittal image demonstrates "hourglass" narrowing of the popliteal artery by an encasing multiloculated, cystic structure. (arrow) B. Axial image suggests continuity of the lesion with both the vessel wall and lateral knee joint (arrow). C. Axial image demonstrates marked circumferential narrowing of the popliteal arterial lumen due to surrounding T2-bright lobulated lesion.
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Imaging suggested continuity of this lesion with both the popliteal arterial wall and lateral knee joint (Fig. 2).
49-year-old male with cystic adventitial disease. US of the right knee. Sagittal Doppler images confirm a focal stenosis within popliteal artery (arrow) with post-stenotic turbulent flow, seen as multicolor flow on color Doppler. There is absence of Doppler flow within the hypoechoic structure surrounding the popliteal artery, representing the cystic lesions (arrowheads).
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Sonographic images confirmed the presence of multilobulated hypoechoic structures without vascular flow, causing focal stenosis of the right popliteal artery (Fig. 3).
49-year-old male with cystic adventitial disease. Low-power microscopic image demonstrating a fibrous-walled adventitial cyst with focal, synovium-like lining arising from the popliteal artery wall.
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Microscopic findings confirmed cystic adventitial disease (Fig. 4).