Kwon Tae Hyung, Cho Kwang Bum, Lee Hyun Jik, Kwon Sun Young, Lee Yoon Suk
Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea.
Department of Pathology, Keimyung University School of Medicine, Daegu, Korea.
Korean J Gastroenterol. 2019 Jan 25;73(1):50-55. doi: 10.4166/kjg.2019.73.1.50.
Sclerosing mesenteritis is a rare benign disease with a prevalence of 0.16-3.4% and is characterized by chronic nonspecific inflammation and extensive fibrosis in the adipose tissue of the mesentery although the exact pathogenesis is still elusive. A 65-year-old woman was referred with suspicion of an abdominal mass and biliary stones on abdominal ultrasonography and CT. Bile duct stones were confirmed by endoscopic ultrasonography and successfully treated by endoscopic retrograde cholangiography with stone removal. Furthermore, a 4.7 cm conglomerated mass on small intestinal mesentery was suspected as sclerosing mesenteritis based on the features on abdominal MRI. However, because it could not be differentiated from malignancy without histologic examination, laparoscopic excisional biopsy was performed; it showed only inflammatory cells with extensive fibrosis. Therefore, the abdominal mass was confirmed as sclerosing fibrosis and the patient was followed-up without any treatments because no mass-related symptoms accompanied the findings. Six months later, abdominal CT showed no significant change in the mass. Herein, we report a rare case of incidentally found idiopathic sclerosing mesenteritis.
硬化性肠系膜膜炎是一种罕见的良性疾病，患病率为0.16%-3.4%，其特征为肠系膜脂肪组织的慢性非特异性炎症和广泛纤维化，尽管确切发病机制仍不清楚。一名65岁女性因腹部超声和CT检查怀疑有腹部肿块和胆结石而前来就诊。内镜超声证实存在胆管结石，并通过内镜逆行胆管造影取石成功治疗。此外，根据腹部MRI特征，怀疑小肠系膜上一个4.7厘米的聚合性肿块为硬化性肠系膜膜炎。然而，由于在没有组织学检查的情况下无法与恶性肿瘤区分，遂进行了腹腔镜切除活检；结果显示只有伴有广泛纤维化的炎性细胞。因此，腹部肿块被确诊为硬化性纤维化，由于检查结果未伴有任何与肿块相关的症状，该患者未接受任何治疗并进行随访。6个月后，腹部CT显示肿块无明显变化。在此，我们报告一例偶然发现的特发性硬化性肠系膜膜炎罕见病例。
