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Lee HJ, Kim JI, Ahn JW, Kim JH, Cheung ME, Park SH, Kim JK, Im S. Spontaneous Regression of Sclerosing Mesenteritis Presenting as a Huge Mass. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2012; 59:317-20. [DOI: 10.4166/kjg.2012.59.4.317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Hyun Jeong Lee
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Jin Il Kim
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Ji Won Ahn
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Jeong Ho Kim
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Mo Eun Cheung
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Soo-Heon Park
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Jae Kwang Kim
- Department of Internal Medicine, The Catholic University of Korea, College of Medicine, Seoul, Korea
| | - Soyoung Im
- Department of Hostipal Pathology, The Catholic University of Korea, College of Medicine, Seoul, Korea
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Bae JH, Kim SH, Ahn SB, Son BK, Jo YJ, Park YS, Jung YM, Chang YS. A Case of Idiopathic Sclerosing Mesenteritis with Retroperitoneal Fibrosis. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2011; 58:221-5. [DOI: 10.4166/kjg.2011.58.4.221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- June Ho Bae
- Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Seong Hwan Kim
- Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Sang Bong Ahn
- Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Byoung Kwan Son
- Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Yun Ju Jo
- Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Young Sook Park
- Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Yu Min Jung
- Department of Internal Medicine, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
| | - Yeon Soo Chang
- Department of Surgery, Eulji General Hospital, Eulji University College of Medicine, Seoul, Korea
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Corradi D, Maestri R, Palmisano A, Bosio S, Greco P, Manenti L, Ferretti S, Cobelli R, Moroni G, Dei Tos AP, Buzio C, Vaglio A. Idiopathic retroperitoneal fibrosis: clinicopathologic features and differential diagnosis. Kidney Int 2007; 72:742-53. [PMID: 17622270 DOI: 10.1038/sj.ki.5002427] [Citation(s) in RCA: 143] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Idiopathic retroperitoneal fibrosis (IRF) is a rare disease often causing obstructive uropathy. We evaluated the clinicopathologic features of 24 patients with IRF to characterize the histopathology of the disease and to provide a framework for the differential diagnosis with other retroperitoneal fibrosing conditions. Retroperitoneal specimens were analyzed by light and electron microscopy and by immunohistochemistry. Most patients presented with abdominal/lumbar pain, constitutional symptoms, and high acute-phase reactants. Overall, 20 had ureteral involvement and 13 developed acute renal failure. The retroperitoneal tissue consisted of a fibrous component and a chronic inflammatory infiltrate with the former characterized by myofibroblasts within a type-I collagen matrix. The infiltrate displayed perivascular and diffuse patterns containing lymphocytes, macrophages, plasma cells, and eosinophils. The perivascular aggregates had a central core of CD20(+) cells and a mantle of CD3(+) cells in equal proportions. In the areas of diffuse infiltrate, CD3(+) cells outnumbered the CD20(+) cells. Most plasma cells were positive for the IgG4 isotype. Small vessel vasculitis was found in the specimens of 11 patients. Our study indicates that a sclerotic background with myofibroblasts associated with a diffuse and perivascular infiltrate mainly consisting of T and B lymphocytes may be a pathological hallmark of IRF.
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Affiliation(s)
- D Corradi
- Department of Pathology and Laboratory Medicine, Pathology Section, University of Parma, Parma, Italy.
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Holubar S, Dwivedi AJ, O'Connor J. Giant Mesenteric Fibromatosis Presenting as Small Bowel Obstruction. Am Surg 2006. [DOI: 10.1177/000313480607200512] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Mesenteric fibromatosis is a proliferative fibroblastic neoplasia of the small intestine mesentery that may occur as a unique or multiple formation. Mesenteric fibromatosis is a rare, locally aggressive neoplasm and may present with abdominal discomfort, abdominal pain, weight loss, or symptoms of ureteral obstruction, mesenteric ischemia, or intestinal obstruction. It is of the utmost importance to distinguish mesenteric fibromatosis from gastrointestinal stromal tumors. Histopathology accurately differentiates between these two distinct entities. The preferred treatment is local surgical excision with a margin of uninvolved tissue. The involvement of important structures like the superior mesenteric artery and the superior mesenteric vein may pose a challenge during resection, but these tumors can be excised and the vessels repaired primarily.
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Affiliation(s)
- Stefan Holubar
- From the Department of Surgery, North Shore University/Long Island Jewish Medical Center, Manhasset, New York
| | - Amit J. Dwivedi
- From the Department of Surgery, North Shore University/Long Island Jewish Medical Center, Manhasset, New York
| | - James O'Connor
- From the Department of Surgery, North Shore University/Long Island Jewish Medical Center, Manhasset, New York
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Abstract
Mesenteric fibromatosis (MF) is a rare, benign tumor commonly associated with Gardner's syndrome. The signs and symptoms in patients with MF are insidious. Patients may present with abdominal pain or discomfort when the tumors reach large sizes, which is typical at the time of diagnosis. Differentiating MF from other neoplasms such as gastrointestinal stromal tumors may present a diagnostic dilemma, especially in patients without any history of familial adenomatous polyposis. In the present report, we discuss a young girl who presented with MF. A pertinent review of the literature is also presented. This case is peculiar in that MF presented at a young age in a patient without history of familial adenomatous polyposis and occurred in the omentum with local invasion to the stomach.
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Affiliation(s)
- Sergio Huerta
- Department of Surgery, University of California, Irvine, Orange, CA 92868, USA.
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Abstract
Mesenteric fibromatosis is a rare, benign fibrous lesion found in the bowel mesentery or the retroperitoneum. Its biological behavior is intermediate between benign fibrous tissue proliferation and fibrosarcoma. Fibromatosis characteristically is locally invasive and tends to recur but does not metastasize. Most reported cases have been in older individuals, and there is a frequent association with familial polyposis coli, previous trauma, and hormonal imbalance. The authors report a case of mesenteric fibromatosis in a 32-month-old girl with a 1-month history of abdominal pain who was discovered to have an abdominal mass. After appropriate investigations, the mass was excised. The pathology report confirmed the diagnosis of fibromatosis. Mesenteric fibromatosis in children, as in adults, presents a management challenge for the surgeon.
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Affiliation(s)
- S A Al Jadaan
- Department of Surgery, King Fahad National Guard Hospital, Riyadh, Saudi Arabia
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Zidi SH, Marteau P, Piard F, Coffin B, Favre JP, Rambaud JC. Enterocolitis cystica profunda lesions in a patient with unclassified ulcerative enterocolitis. Dig Dis Sci 1994; 39:426-32. [PMID: 8313829 DOI: 10.1007/bf02090219] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Enteritis cystica profunda and diffuse colitis cystica profunda are exceedingly rare conditions. We report here the first case in which these two entities are associated in one patient. This 48-year-old woman presented initially with a solitary ulcer of the rectum and developed later deep ileal and colonic ulcerations with intervening normal mucosa, polypoid masses, and a dense fibrosis of the bowel wall. Colon and ileum specimens demonstrated submucosal mucous cysts and occasionally herniation of mucosal epithelium into the submucosa, which led to the diagnosis of enteritis and colitis cystica profunda. The exact nature of the underlying ileocolonic disease, which necessitated colectomy and extensive ileal resection, remained undetermined although an aggravating role of iterative surgical procedures is possible. Enteritis cystica profunda and diffuse colitis cystica profunda therefore seem to share a common pathogeny and have to be considered as lesions complicating an underlying disease rather than specific and autonomic diseases.
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Affiliation(s)
- S H Zidi
- Service de Gastro-entérologie, Hôpital Saint-Lazare, Paris, France
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Abstract
We report a case of primary retractile mesenteritis presenting as acute abdominal pain requiring surgery in a 3-year-old boy. At laparotomy, a hemoperitoneum was discovered and the diagnosis of primary mesenteritis was made with the aid of frozen section biopsy of the small bowel mesentery. No resection was necessary, and he made an uneventful recovery and remains well on follow-up.
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Affiliation(s)
- C F Davis
- Department of Pediatric Surgery, Children's National Medical Center, Washington, DC 20010
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