This is gouty tophi . It typically appears as firm, irregular, and multinodular masses, often with a chalky white or yellowish appearance due to the deposition of monosodium urate crystals. These nodules may be surrounded by a fibrous capsule and can vary in size from a few millimetres to several centimetres. Areas of haemorrhage, fibrosis, or secondary inflammation may be present, particularly in long-standing lesions. In advanced cases, adjacent bone or joint structures may show erosions, deformities, or evidence of chronic synovitis.

Section shows nodular aggregates of acellular, amorphous, feathery, pale eosinophilic material surrounded by histiocytes and multinucleated giant cells of the foreign body type. Mild to moderate lymphoplasma cells infiltrations are seen. No features of malignancy.

Gouty tophi