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Abstract
Mesenteries are extensions of the visceral and parietal peritoneum consisting of fat, vessels, nerves, and lymphatics. Mesenteric masses have a wide differential diagnosis with neoplastic, infectious, or inflammatory etiologies and can either be solid or cystic. Imaging features are critical for the diagnosis. We review the epidemiology, imaging spectrum, and differentiating features and treatment of mesenteric masses.
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Fukuda M, Miyake T, Matsubara A, Ikai N, Tanaka E, Namura T, Wada Y, Noujima M, Moritani S, Murakami K, Andoh A, Tani M, Kushima R. Sclerosing Mesenteritis Mimicking IgG4-related Disease. Intern Med 2020; 59:513-518. [PMID: 31708540 PMCID: PMC7056383 DOI: 10.2169/internalmedicine.3221-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
A 72-year-old man was followed as an outpatient at our hospital for 6 years after surgery for small cell carcinoma of left adrenal gland origin. Follow-up abdominal computed tomography showed a 6-cm mass in the left lower mesentery. The patient underwent open laparotomy. The histological diagnosis was sclerosing mesenteritis. The previous specimens of the left adrenal mass were then re-examined with a microscope, and panniculitis was found around the small cell carcinoma. Both lesions were histologically similar to IgG4-related disease (RD), but they did not completely meet the diagnostic criteria of IgG4-RD clinically or histologically.
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Affiliation(s)
- Masahide Fukuda
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Japan
- Department of Gastroenterology, Oita University, Faculty of Medicine, Japan
| | - Toru Miyake
- Department of Surgery, Shiga University of Medical Science, Japan
| | - Akiko Matsubara
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Japan
| | - Nobuyasu Ikai
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Japan
| | - Eri Tanaka
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Japan
| | - Tomo Namura
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Japan
| | - Yasuhiro Wada
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Japan
- Department of Gastroenterology, Oita University, Faculty of Medicine, Japan
| | - Mai Noujima
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Japan
| | - Suzuko Moritani
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Oita University, Faculty of Medicine, Japan
| | - Akira Andoh
- Division of Gastrointestinal Endoscopy, Shiga University of Medical Science Hospital, Japan
| | - Masaji Tani
- Department of Surgery, Shiga University of Medical Science, Japan
| | - Ryoji Kushima
- Division of Diagnostic Pathology, Department of Clinical Laboratory Medicine, Shiga University of Medical Science Hospital, Japan
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Abstract
Sclerosing mesenteritis is a rare benign disease presenting with chronic inflammation of the mesenteric adipose tissue and variable degrees of fibrosis. A 47-year-old black man presented to the emergency department with symptoms of small bowel obstruction, requiring surgical treatment. The laparotomy revealed a stenosis of the distal ileum with mesenteric thickening and an enterectomy was performed. The postoperative period was complicated by the maintenance of bowel obstruction. The patient underwent a second laparotomy, in which the fibrosing process of the mesentery was much aggravated, and an ileo-colic resection was needed. After knowledge of the histological diagnosis, the patient was started on immunomodulators with clinical improvement. At 26 months of follow-up, patient is asymptomatic under medical treatment. This is the first report, to our knowledge, of a patient with progressive fibrosis in such short period of time requiring surgical re-intervention for bowel obstruction, owing to sclerosing mesenteritis.
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Affiliation(s)
- Sofia Costa Corado
- Serviço de Cirurgia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Heitor Almeida
- Serviço de Cirurgia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
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Er C, Tey VHT, Kuthiah N, Aravamudan VM. A case of mesenteric panniculitis associated with metastatic poorly differentiated cancer of unknown primary site. Oxf Med Case Reports 2019; 2019:omz023. [PMID: 31001427 PMCID: PMC6463832 DOI: 10.1093/omcr/omz023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 02/22/2019] [Accepted: 03/02/2019] [Indexed: 11/15/2022] Open
Abstract
Mesenteric panniculitis is the inflammation of intestinal mesentery. It may be associated with malignancy. We present a case of mesenteric panniculitis that manifested as unresolved fever which subsequently was found to be due to poorly differentiated metastatic carcinoma.
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Affiliation(s)
- Chaozer Er
- Department of General Medicine, Woodlands Health Campus, 2 Yishun Central 2, Singapore
| | | | - Navin Kuthiah
- Department of General Medicine, Woodlands Health Campus, 2 Yishun Central 2, Singapore
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