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Asymptomatic sclerosing mesenteritis with follicular lymphoma in a 30-year-old male: a case report
EP33178
Poster Title: Asymptomatic sclerosing mesenteritis with follicular lymphoma in a 30-year-old male: a case report
Submitted on 18 Oct 2020
Author(s): Nagamoto, T., Tirado E., Rehman A.
Affiliations: Good Samaritan Surgical Specialists
This poster was presented at Good Samaritan Health Services
Poster Views: 104
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Poster Information
Abstract: Sclerosing mesenteritis describes an idiopathic primary fibroinflammatory disorder that directly involves the mesentery and results in fibrosis. Majority of cases show small intestine involvement, and the causes can be idiopathic, trauma, autoimmune, malignant and paraneoplastic. We report a case of a 30-year-old man who presented to our department with slightly elevated liver enzymes and a past medical history of obesity (BMI 44.8) and mixed hyperlipidemia. CT Abdomen showed enlarged mesenteric lymph nodes measuring between 2.2-2.7 cm and coalescent, rim-enhancing, round cystic lesions with low-attenuation in the root of the small bowel mesentery. Mesenteritis has been found to be associated with small bowel obstructions and cancers including lymphoma, breast cancer, lung cancer, melanoma and colon cancer. Due to the nonspecific symptoms, diagnosis is often challenging. CT scans are often suggestive but not necessarily diagnostic. Various treatment regimens have been used, although often anecdotal. Clinicians must maintain a high level of suspicion for the disease, and this must be included in the differential diagnosis of a case of unexplained abdominal pain, elevated LFTs, small bowel obstruction, or gastrointestinal malignancies.
Summary: Here we report an unusual case of a previously healthy 30 year old male with no surgical history with sclerosing mesenteritis who presented and elevated liver enzymes that was found out to be related to follicular lymphoma.

References:
Akram, Salma et al. “Sclerosing mesenteritis: clinical features, treatment, and outcome in ninety-two patients.” Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association vol. 5,5 (2007): 589-96; quiz 523-4. doi:10.1016/j.cgh.2007.02.032

Chen, T S, and E A Montgomery. “Are tumefactive lesions classified as sclerosing mesenteritis a subset of IgG4-related sclerosing disorders?.” Journal of clinical pathology vol. 61,10 (2008): 1093-7. doi:10.1136/jcp.2008.057869

Daskalogiannaki, M et al. “CT evaluation of mesenteric panniculitis: prevalence and associated diseases.” AJR. American journal of roentgenology vol. 174,2 (2000): 427-31. doi:10.2214/ajr.174.2.1740427
Harvin, Glenn, and Adam Graham. “Sclerosing Mesenteritis: A Rare Cause of Small Bowel Obstruction.” Case reports in gastroenterology vol. 10,1 63-7. 19 May. 2016, doi:10.1159/000444413

Liang, C., Yang, M., Chen, P. et al. Sc
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