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Sclerosing mesenteritis, mesenteric panniculitis and mesenteric lipodystrophy: a single entity?
T S Emory1, J M Monihan, N J Carr
1Department of Hepatic and Gastrointestinal Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
The American Journal of Surgical Pathology
|April 1, 1997
Summary
Sclerosing mesenteritis (SM), mesenteric panniculitis (MP), and mesenteric lipodystrophy (ML) are likely variants of a single clinical entity. Histologic features often overlap, suggesting "sclerosing mesenteritis" as the most appropriate diagnostic term.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Mesenteric lipodystrophy (ML), mesenteric panniculitis (MP), and sclerosing mesenteritis (SM) are distinct conditions.
- Histologic evaluation of these conditions involves grading fibrosis, inflammation, and fat necrosis.
Purpose of the Study:
- To determine if ML, MP, and SM represent distinct entities or variants of a single condition.
- To evaluate clinical subgroups and features that may differentiate these conditions.
Main Methods:
- Review of 84 cases coded as ML, MP, or SM.
- Grading of fibrosis, inflammation, and fat necrosis in mesenteric tissues.
- Evaluation of clinical, demographic, and gross features.
Main Results:
- No significant gender or racial predominance observed; average patient age was 60.
- Abdominal pain and palpable mass were common presentations.
- Small bowel mesentery was the most frequent site of involvement, presenting as a mass or diffuse thickening.
- All cases showed fibrosis, chronic inflammation, and fat necrosis, often with mixed components.
- Clinical and gross features did not reliably differentiate between ML, MP, and SM.
- Of 39 patients followed postoperatively, none died from these lesions.
Conclusions:
- ML, MP, and SM appear to be histologic variants of a single clinical entity.
- "Sclerosing mesenteritis" is proposed as the most appropriate diagnostic term due to overlapping features.