Piombino Eliana, D'Agata Costanza, Picardo Maria Carolina, Caltavuturo Claudia, Magro Gaetano, Colarossi Cristina, Memeo Lorenzo
Pathology Unit, Department of Experimental Oncology, Mediterranean Institute of Oncology, Catania, Italy.
Surgical Oncology Unit, Department of Experimental Oncology, Mediterranean Institute of Oncology, Catania, Italy.
Front Surg. 2021 Aug 20;8:722312. doi: 10.3389/fsurg.2021.722312. eCollection 2021.
Sclerosing mesenteritis (SM) is a rare fibroinflammatory disorder that involves mesenteric adipose tissue, more frequently localized in the small intestine, with an insidious clinical presentation having symptoms related to mass effect, usually resulting in bowel obstruction, mesenteric ischemia, as well as rapid weight loss. We report a case of a 23-year-old male presenting with palpable abdominal mass, mesogastric pain, and a history of rapid weight loss, who underwent exploratory laparoscopy. A hemorrhagic and gelatinous nodular tumor mass of the mesentery was identified and the surgical procedure was converted to a laparotomic approach. Histologically, the mass was composed of a proliferation of bland-looking spindle cells with slightly eosinophilic cytoplasm and elongated normochromatic nuclei with mild nuclear atypia, haphazardly set in a collagenized stroma; fat necrosis and inflammatory cells (lymphocytes, plasma-cells, and histiocytes) were also evident. The diagnosis of sclerosing mesenteritis was made. Our case emphasizes that histology remains pre-eminent for a correct diagnosis of SM, as pre-operative radiological-based diagnosis is non-specific.
硬化性肠系膜脂膜炎（SM）是一种罕见的纤维炎症性疾病，累及肠系膜脂肪组织，更常见于小肠，临床表现隐匿，有与占位效应相关的症状，通常导致肠梗阻、肠系膜缺血以及体重迅速下降。我们报告一例23岁男性患者，表现为可触及的腹部肿块、中腹部疼痛及体重迅速下降史，接受了 exploratory laparoscopy（此处原文有误，推测可能是“exploratory laparotomy”，即剖腹探查术）。术中发现肠系膜有一个出血性、胶冻样结节状肿瘤肿块，手术方式转为开腹手术。组织学检查显示，肿块由增生的外观温和的梭形细胞组成，细胞质轻度嗜酸性，细胞核细长、正常染色质，有轻度核异型性，随机分布于胶原化的间质中；脂肪坏死和炎症细胞（淋巴细胞、浆细胞和组织细胞）也很明显。最终诊断为硬化性肠系膜脂膜炎。我们的病例强调，组织学检查对于SM的正确诊断仍然至关重要，因为术前基于影像学的诊断是非特异性的。
