Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2016; 4(4): 108-111
Published online Apr 16, 2016. doi: 10.12998/wjcc.v4.i4.108
Rare case of sclerosing mesenteritis and low grade follicular lymphoma
Seema Shah, Gillian Mahy, Enrico Roche
Seema Shah, Gillian Mahy, Enrico Roche, the Townsville Hospital, Douglas, Townsville, QLD 4810, Australia
Author contributions: Shah S and Roche E collected patient data, designed and wrote the paper; Roche E contributed in revising the work critically for important intellectual content and along with Mahy G contributed by giving final approval of the version to be published.
Institutional review board statement: This case report was exempt from the Institutional review board standards at the Townsville Hospital.
Informed consent statement: The patient involved in this study gave his verbal informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Seema Shah, Gastroenterology Registrar, the Townsville Hospital, 100 Angus Smith Drive, Douglas, Townsville, QLD 4810, Australia.
Telephone: +61-7-44331111 Fax: +61-7-44332381
Received: October 12, 2015
Peer-review started: October 14, 2015
First decision: November 11, 2015
Revised: December 6, 2015
Accepted: January 8, 2016
Article in press: January 11, 2016
Published online: April 16, 2016

An unusual case of long standing sclerosing mesenteritis; initially presented with recurrent abdominal pain and a mesenteric mass with surrounding fat oedema and stranding with a pseudocapsule and fat ring sign were clearly visualised on the initial computed tomography scan. Laparotomy showed diffuse thickening at the root of the mesentery and histology from this specimen revealed fat necrosis and reactive lymphoid tissue consistent with sclerosing mesenteritis. Initial treatment with steroids and tamoxifen relieved the symptoms and the mass. He was maintained on tamoxifen. Three years later he developed a recurrence of his symptoms and abdominal mass that responded to a course of steroids. Two years following this, he developed a follicular Hodgkin’s lymphoma.

Keywords: Sclerosing mesenteritis, Computerised tomography scan, Magnetic resonance imaging scans, Tamoxifen, Steroids, Hodgkin’s lymphoma

Core tip: Sclerosing mesenteritis is a rare disease but clinicians should be mindful of this condition that can present with various clinical symptoms including recurrent abdominal pain. The case we describe showed typical features of sclerosing mesenteritis and demonstrated good clinical and radiological response to steroids and tamoxifen. Five years later he developed a recurrence of the abdominal mass that showed transformation into a lymphoma.