Colon tumor
Mesenchymal tumors
Sclerosing mesenteritis

Topic Completed: 1 December 2016

Revised: 15 January 2019, last major update December 2016

Copyright: (c) 2003-2017,, Inc.

PubMed search: sclerosing mesenteritis colon

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Cite this page: Gonzalez R. Sclerosing mesenteritis. website. Accessed May 23rd, 2019.
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

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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

Images hosted on PathOut server:

Courtesy of 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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