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Updated: Apr 23, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Mesenteric panniculitis: prevalence, clinicoradiological presentation and 5-year follow-up
N van Putte-Katier1, E F H van Bommel, O E Elgersma
11 Department of Radiology, Albert Schweitzer Ziekenhuis, Netherlands.
Objective:
To determine prevalence, clinicoradiological characteristics and outcome of patients with mesenteric panniculitis (MP) in a large hospital-based population.
Methods:
Consecutive abdominal CT examinations of 3820 patients were evaluated for MP. Clinical characteristics, therapy and outcome of patients with MP were evaluated during a 5-year follow-up period. A matched pair analysis was performed to further investigate the relation between MP and malignancy.
Results:
94 (2.5%) patients with MP were identified (mean age, 66.6 ± 11.2 years, 70.2% male). MP coexisted with malignancy (especially prostatic carcinoma) in 48.9% of patients, and this was slightly but significantly higher than in age- and sex-matched control patients (n = 188, 46.3%). In 48 patients, MP was presumed to be idiopathic. The most frequent presenting symptom was pain (54.3%). Laboratory findings revealed increased acute-phase reactants in half of the patients with MP. CT findings included increased density of mesenterial fat (mean, -56.8 ± 10.8 HU), fat ring sign, tumoural pseudocapsule and small soft-tissue nodules. Patients with MP (14.6%) developed significantly more malignancies during a 5-year follow-up than did the control group (6.9%). One patient was treated with prednisone without satisfactory response.
Conclusion:
The prevalence of MP in this study was 2.5%. In most patients, radiologic features included increased mesenteric fat density, fat ring sign and small soft-tissue nodules. MP was associated with a significant higher prevalence of coexisting malignancies and a higher prevalence of future cancer development.
Advances In Knowledge:
A more accurate prevalence of MP on CT is demonstrated. An underlying malignancy may play a role.
Insights
Mesenteric panniculitis (MP) affects 2.5% of patients, often presenting with increased mesenteric fat density on CT scans. This condition is linked to a higher prevalence of existing and future malignancies.
Area of Science:
- Radiology
- Gastroenterology
- Oncology
Background:
- Mesenteric panniculitis (MP) is a rare condition affecting the mesentery.
- Understanding its prevalence and association with malignancy is crucial for patient management.
Purpose of the Study:
- To determine the prevalence, clinicoradiological characteristics, and outcomes of patients with MP.
- To investigate the association between MP and malignancy.
Main Methods:
- Retrospective analysis of 3820 abdominal CT scans to identify MP.
- Clinical data and 5-year follow-up of MP patients.
- Matched pair analysis to assess the MP-malignancy relationship.
Main Results:
- MP prevalence was 2.5% (94 patients).
- Associated malignancies (especially prostate cancer) were found in 48.9% of MP patients.
- MP patients had a higher incidence of developing malignancies over 5 years (14.6% vs. 6.9% in controls).
- Common CT findings included increased mesenteric fat density, fat ring sign, and soft-tissue nodules.
Conclusions:
- MP has a prevalence of 2.5% in this hospital-based population.
- Radiological features include increased mesenteric fat density, fat ring sign, and nodules.
- MP is associated with a significantly higher prevalence of coexisting and future malignancies, suggesting a potential role for underlying cancer.
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