Colon tumor - Idiopathic retractile mesenteritis

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Colon tumor

Mesenchymal tumors

Idiopathic retractile mesenteritis of colon

Reviewers: Charanjeet Singh, M.D. (see Reviewers page)
Revised: 15 April 2012, last major update April 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Also called mesenteric panniculitis (Dis Colon Rectum 1987;30:962)
● Uncommon non-neoplastic idiopathic condition usually affecting small bowel, which can also cause thickening and shortening of colonic mesentery (JBR-BTR 2011;94:241)
● Common in rural areas of Peru (Rev Gastroenterol Peru 1998;18 Suppl 1:114), otherwise rare
● Usually men age 40+ years; associated with intestinal obstruction but no other systemic symptoms

Case reports
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● 12 year old girl (Pediatr Radiol 1997;27:342)
● 40 year old man with large mesenteric mass (Arch Pathol Lab Med 2001;125:443)
● 46 year old woman (Surg Today 1996;26:435)

Gross description
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● Markedly thickened and rubbery mesentery with twist of bowel

Gross images
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Various images

Micro description
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● Fibrosis with massive accumulation of dense collagen, fat necrosis, chronic inflammation especially around the vessels and variable focal calcification
● Minimal atypia, no / minimal mitotic figures
● Diagnosis based on H&E and excluding other disorders; no specific immunostains

Micro images
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Various images

Dense collagen and chronic inflammatory cells

Infiltration of mesentery by foamy macrophages

Angiomatoid proliferation with microthrombi (figure 5)

Differential diagnosis
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● Fibromatosis
● Idiopathic retroperitoneal fibrosis
● Inflammatory myofibroblastic tumor
● Liposarcoma (Chirurg 2001;72:742)
● Lymphoma: sclerosing

End of Colon tumor > Mesenchymal tumors > Idiopathic retractile mesenteritis of colon

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