Colon (tumor & nontumor)
Other nonneoplastic
Sclerosing mesenteritis

Topic Completed: 1 December 2016

Minor changes: 9 May 2020

Copyright: 2003-2020,, Inc.

PubMed search: sclerosing mesenteritis colon

Raul S. Gonzalez, M.D.
Page views in 2020 to date: 674
Cite this page: Gonzalez R. Sclerosing mesenteritis. website. Accessed August 7th, 2020.
Definition / general
  • Uncommon nonneoplastic condition that causes thickening and shortening of colonic mesentery (JBR-BTR 2011;94:241)
Essential features
  • Benign fibrotic / inflammatory condition involving the mesentery
  • Some cases are IgG4 related
  • Older terms include idiopathic retractile mesenteritis, mesenteric panniculitis and mesentery lipodystrophy (Am J Surg Pathol 1997;21:392)
  • Affects the mesentery; small bowel mesentery is involved more often than colonic
Clinical features
Radiology description
  • Mesentery can show fat attenuation or a fibrofatty mass
Case reports
  • Various medications (including corticosteroids) and surgery, depending on clinical severity (Int Arch Med 2011;4:17)
Clinical images

Images hosted on other servers:

Thick mesentery with yellow nodules

Gross description
  • Markedly thickened and rubbery mesentery causing bowel twisting
Gross images

Images hosted on other servers:

Distorting bowel loops

Microscopic (histologic) description
  • Fibrosis with dense collagen, fat necrosis, chronic inflammation (especially around vessels) and variable focal calcification
  • Minimal atypia, no or few mitoses
  • IgG4 related cases lack fat necrosis and show obliterative phlebitis and increased inflammation
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D.

Fibrosis and chronic inflammation

Fibrosis and chronic inflammation, high power

Fibrosis, chronic inflammation and fat necrosis

Images hosted on other servers:

Fat necrosis, sclerosing fibrosis, chronic inflammation

Fat necrosis with numerous lipid laden macrophages

Radiology, gross and microscopic images

Positive stains
  • IgG4 (in some cases)
Negative stains
Differential diagnosis
Additional references
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