A Case of IgG4-related Sclerosing Mesenteritis.
A 60-year-old African-American male presented to the emergency department with abdominal pain and distention associated with decreased appetite and weight loss for several weeks. A computed tomography (CT) scan of the abdomen and pelvis showed an 8 cm mesenteric mass with surrounding stranding and poorly defined borders. The patient underwent exploratory laparotomy and complete resection of the mass since the frozen section could not give a definite diagnosis. Histopathology showed fibro-adipose tissue with lymphoid hyperplasia, vague nodular collections of foamy histiocytes with giant cell reaction, marked chronic inflammation, fat necrosis, and prominent sclerosis/fibrosis. Methenamine silver and acid-fast stains were negative for fungal and mycobacterial organisms respectively. Examination of tissue with immunohistostains showed increased immunoglobulin G4 (IgG4)-positive plasma cells. Other features observed were scattered areas of phlebitis, pockets of tissue eosinophilia, and focal storiform fibrosis leading to the diagnosis of IgG4-related sclerosing mesenteritis. The patient did not require steroids after the surgical resection and was disease free at six-month follow up.
Published In/Presented At
Butt, Z., Alam, S. H., Semeniuk, O., Singh, S., Chhabra, G. S., & Tan, I. J. (2018). A Case of IgG4-related Sclerosing Mesenteritis. Cureus, 10(2), e2147. https://doi.org/10.7759/cureus.2147
Medicine and Health Sciences
Department of Medicine, Department of Medicine Fellows and Residents, Fellows and Residents