Sclerosing Mesenteritis: Clinical Features, Treatment, and Outcome in Ninety-Two Patients  Salma Akram, Darrell S. Pardi, John A. Schaffner, Thomas C. Smyrk  Clinical Gastroenterology and Hepatology  Volume 5, Issue 5, Pages 589-596 (May 2007) DOI: 10.1016/j.cgh.2007.02.032 Copyright © 2007 AGA Institute Terms and Conditions

Figure 1 (A) Axial image from CT scan of abdomen performed with intravenous contrast material. A central mesenteric soft-tissue mass (8.5 × 4.5 cm) (thin arrow) encases branches of the superior mesenteric artery and tributaries of the superior mesenteric vein. The mass enhances poorly and contains a 2-cm calcification internally (thick arrow). In this case the margins of the mass are not spiculated. There is no surrounding adenopathy or tethering of the nearby bowel. This mass is associated with small bowel mural and mesenteric edema as well as ascites. (B) Repeat CT scan of abdomen with intravenous contrast performed 6 months after initiation of tamoxifen therapy shows a reduction in the size of the central mesenteric soft-tissue mass (6.5 × 3.5 cm) (thin arrow). Ascites and small bowel mural edema persist. Clinical Gastroenterology and Hepatology 2007 5, 589-596DOI: (10.1016/j.cgh.2007.02.032) Copyright © 2007 AGA Institute Terms and Conditions

Figure 2 Axial image from CT scan of abdomen performed with intravenous contrast. Subtle increased density of central mesenteric fat without adenopathy (arrow). There is no mass effect on the mesenteric blood vessels. Clinical Gastroenterology and Hepatology 2007 5, 589-596DOI: (10.1016/j.cgh.2007.02.032) Copyright © 2007 AGA Institute Terms and Conditions

Figure 3 (A) Retractile mesenteritis: fibrotic tissue with scant inflammatory cells (hematoxylin-eosin stain; original magnification, 200×). (B) Mesenteric panniculitis: chronic inflammatory cells in mesenteric fat with slight fibrosis (hematoxylin-eosin stain; original magnification, 200×). (C) Mesenteric lipodystrophy: foamy macrophages and lymphocytes in mesenteric fat (hematoxylin-eosin stain; original magnification, 200×). Clinical Gastroenterology and Hepatology 2007 5, 589-596DOI: (10.1016/j.cgh.2007.02.032) Copyright © 2007 AGA Institute Terms and Conditions

Figure 4 Proposed treatment algorithm for sclerosing mesenteritis. Clinical Gastroenterology and Hepatology 2007 5, 589-596DOI: (10.1016/j.cgh.2007.02.032) Copyright © 2007 AGA Institute Terms and Conditions