Symptomatic Mesenteric Panniculitis Associated With a Suspicious Cecal Lesion: A Case Report

Mesenteric panniculitis is an uncommon inflammatory disorder involving the adipose tissue of the mesentery. Although it is frequently discovered incidentally on computed tomography (CT), it may occasionally present with nonspecific abdominal symptoms, making diagnosis challenging. We report the case of an 85-year-old woman who presented with a three-day history of acute abdominal pain. Contrast-enhanced abdominopelvic CT demonstrated increased attenuation of the mesenteric fat with small subcentimeter mesenteric lymph nodes, producing a "misty mesentery" appearance consistent with mesenteric panniculitis. The examination also revealed irregular circumferential thickening of the cecal wall, suspicious for an underlying malignant lesion. No bowel obstruction, hepatic metastasis, peritoneal nodularity, ascites, suspicious enlarged regional lymph nodes, or metastatic deposits in the visualized lung bases were identified on CT. The patient was referred for colonoscopic and histopathological evaluation; however, pathological confirmation was not documented in the available medical record. This case highlights the role of CT in identifying mesenteric panniculitis and detecting associated suspicious abdominal findings that may require targeted diagnostic workup. Awareness of this entity is important, particularly in symptomatic elderly patients, because careful CT assessment may identify additional clinically relevant abnormalities requiring further evaluation.