SCLEROSING MESENTERITIS, MESENTERIC PANNICULITIS AND MESENTERIC LIPODYSTROPHY - A SINGLE ENTITY

We reviewed 84 cases coded as mesenteric lipodystrophy (ML), mesenteri c panniculitis (MP), or retractile mesenteritis and sclerosing mesente ritis (SM), grading fibrosis, inflammation, and fat necrosis, and eval uating clinical subgroups. There was no gender or racial predominance. Patient age range was 23-87 years (average 60). Patients most often p resented with abdominal pain or a palpable mass. A history of trauma o r surgery was present in four of 84 patients. The most common site of involvement was the small bowel mesentery as a single mass (58 of 84) with an average size of 10 cm, multiple masses (15 of 84), or diffuse mesenteric thickening (11 of 84). All patients had some degree of fibr osis, chronic inflammation, and fat necrosis. Although a few patients showed a sufficient prominence of fibrosis, inflammation, or fat necro sis to permit a separation into SM, MP, or Mi,, respectively, in most patients these three components were too mixed for a clear separation. The clinical, demographic, and gross features did not help in definin g these three entities. Contributors diagnosed 12 as sarcoma. Of 39 pa tients followed beyond the postoperative period, none died of these le sions. We conclude that SM, MP, and ML appear to represent histologic variants of one clinical entity, and in most cases ''sclerosing mesent eritis'' is the most appropriate diagnostic term.