Relationship between mesenteric abnormalities on computed tomography and malignancy: clinical findings and outcomes of 359 patients.

BACKGROUND

Mesenteric abnormalities are detected on abdominal computed tomography (CT) performed for various indications.

GOALS

Determine the risk of malignancy on follow-up of patients with these abnormalities without a preexisting malignancy.

STUDY

Data were collected on all patients at NorthShore University HealthSystem with abdominal CT scan reports of mesenteric abnormalities labeled as "panniculitis" from January 2005 to April 2010.

RESULTS

Three hundred fifty-nine patients were identified, 81 (22.6%) had a known malignancy at the time of the index abdominal CT scan. Nineteen (6.8%) of the 278 had a new diagnosis of malignancy on evaluation of the findings of the index CT scan. Among the 240 (86.33%) that did not have a notation of the abnormality in their medical record, 11 (4.58%) developed a malignancy during the study period. Sixty-eight of the 248 (24.46%) without a known malignancy had diseases associated with mesenteric abnormalities. The presence of these were associated with a reduction in the likelihood that the abnormalities are associated with new or delayed diagnosis of a malignancy (odds ratio, 0.197; 95% confidence interval, 0.0045-0.8501; P=0.013). Progression of underlying malignancy was unlikely in those where the mesenteric abnormalities did not worsen in appearance on follow-up CT scans (odds ratio, 0.03268; 95% confidence interval, 0.0028-0.3761; P=0.0061).

CONCLUSIONS

In the presence of an underlying disease associated with these findings, the subsequent finding of a malignancy is less likely. In addition, neglect of these findings may result in delayed diagnosis of cancer.