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Mesenteric panniculitis: comparison of computed tomography findings in patients with and without malignancy

Authors Al-Omari MH, Qararha K, Garaleh M, Smadi MM, Bani Hani M, Elheis M

Received 10 August 2018

Accepted for publication 30 November 2018

Published 27 December 2018 Volume 2019:12 Pages 1—8


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Anastasios Koulaouzidis

Mamoon H Al-Omari,1 Khaleel Qararha,1 Mohammed Garaleh,1 Mahmoud M Smadi,2 Mohammed Bani Hani,3 Mwaffaq Elheis1

1Department of Radiology, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan; 2Department of Mathematics and Statistics, Jordan University of Science and Technology, Irbid, Jordan; 3Department of Surgery, Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan

Purpose: The aim was to compare computed tomography (CT) findings between patients with mesenteric panniculitis (MP) with and without known malignancy.
Patients and methods: We retrospectively analyzed 116 consecutive patients who were diagnosed with MP on the basis of CT findings and categorized them according to the absence (Group 1: 73 patients) or presence (Group 2: 43 patients) of malignancy. Patient age and sex, diameter, size, mass effect, location, and fat density of the MP mass, presence of a pseudocapsule and/or halo sign, and lymph node status were compared between the two groups.
Results: MP tends to be more common in males, and this trend shows statistical significance when combining the findings for both groups (P=0.041). Patients in Group 1 were significantly younger than those in Group 2 (54.29 vs 64.77 years, P=0.001). A well-defined fatty mass at the small bowel root was observed in all patients. The halo sign was present in most cases in both groups. A pseudocapsule was observed in 36 patients (49%) in Group 1 and 29 (67%) in Group 2 (P=0.045). The average craniocaudal diameter of the MP masses on the sagittal view was 11.14 and 12.5 cm in Groups 1 and 2, respectively (P=0.005). The MP fat density was less negative in patients with malignancy (–66 vs –76 HU, P=0.001). Lymph node status was similar in both groups.
Conclusion: Detailed CT features should be evaluated in patients with MP, as some of these features may indicate an associated malignancy, necessitating further investigation and close follow-up.

Keywords: imaging, mesenteric inflammation, paraneoplastic

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