Shah Seema, Mahy Gillian, Roche Enrico
Seema Shah, Gillian Mahy, Enrico Roche, the Townsville Hospital, Douglas, Townsville, QLD 4810, Australia.
World J Clin Cases. 2016 Apr 16;4(4):108-11. doi: 10.12998/wjcc.v4.i4.108.
An unusual case of long standing sclerosing mesenteritis; initially presented with recurrent abdominal pain and a mesenteric mass with surrounding fat oedema and stranding with a pseudocapsule and fat ring sign were clearly visualised on the initial computed tomography scan. Laparotomy showed diffuse thickening at the root of the mesentery and histology from this specimen revealed fat necrosis and reactive lymphoid tissue consistent with sclerosing mesenteritis. Initial treatment with steroids and tamoxifen relieved the symptoms and the mass. He was maintained on tamoxifen. Three years later he developed a recurrence of his symptoms and abdominal mass that responded to a course of steroids. Two years following this, he developed a follicular Hodgkin's lymphoma.
一例罕见的长期硬化性肠系膜炎症;最初表现为反复腹痛,肠系膜肿块伴周围脂肪水肿及条索状改变,在初次计算机断层扫描中清晰可见假包膜和脂肪环征。剖腹探查显示肠系膜根部弥漫性增厚,该标本的组织学检查显示脂肪坏死和反应性淋巴组织,符合硬化性肠系膜炎症。最初使用类固醇和他莫昔芬治疗可缓解症状和肿块。他一直服用他莫昔芬。三年后,他的症状和腹部肿块复发,对一个疗程的类固醇治疗有反应。此后两年,他患上了滤泡性霍奇金淋巴瘤。