Mesenteric panniculitis: comparison of computed tomography findings in patients with and without malignancy

Figures & data

Figure 1 Abdominal computed tomography scans showing the classical signs of mesentric panniculitis.

Notes: (A) Sign 1: axial view showing a well-defined mesenteric fatty mass (arrow) with mass effect on adjacent bowel loops (arrowheads). (B) Sign 2: axial view showing higher density of the mass (small circle) than the adjacent abdominal fat (large circle). (C) Sign 3: sagittal view showing the presence of blood vessels (arrowhead) and small lymph nodes (arrow) inside the mass. (D) Sign 4: coronal view showing the “halo sign” around the lymph nodes and mesenteric vessels (arrow). (E) Sign 5: axial view showing the presence of a hyperattenuating stripe around the mass, known as a pseudocapsule (arrow).

Table 1 Distribution of MP in both groups according to age and gender

Criteria	Group 1 (73)	Group 2 (43)	P-value
Age (years), mean ± SD	54.29±13.03	64.77±11.41	0.001
Gender, M:F	45:28		0.060
M:F		24:19	0.542
Mt:Ft	69:47		0.041

Notes: Ft, total number of F in both groups; Mt, total number of M in both groups.

Abbreviations: F, female; M, male; MP, mesenteric panniculitis.

Figure 2 Percentage of mesenteric panniculitis cases in both groups according to age group.

Table 2 Associated malignancies of the patients in Group 2

Type of malignancy	Number	Percentage
Breast	10	23
Lymphoma	8	19
Colorectal	6	14
Lung	4	9
Bladder	3	7
Prostate	2	4.7
Endometrial	2	4.7
Multiple myeloma	2	4.7
Carcinoid	1	2.3
Sarcoma	1	2.3
Cholangiocarcinoma	1	2.3
CML	1	2.3
Pancreatic	1	2.3
Ovarian	1	2.3

Abbreviation: CML, chronic myeloid leukemia.

Table 3 CT characteristics of mesenteric panniculitis in both groups

CT findings	Group 1: n (%)	Group 2: n (%)	Total, n (%)	P-value
Sign 1: fatty mass lesion in the small intestinal mesentery	73 (100)	43 (100)	116 (100)	1.0
Sign 2: hyperattenuation of the fat	73 (100)	43 (100)	116 (100)	1.0
Sign 3: lymph nodes in the fatty mass	73 (100)	43 (100)	116 (100)	1.0
Sign 4: halo surrounding the lymph nodes or vessels	63 (86)	37 (86)	100 (86)	0.967
Sign 5: pseudocapsule	36 (49)	29 (67)	65 (56)	0.045

Abbreviation: CT, computed tomography.

Table 4 Total number of PC

Number of PC	Group 1: n/N (%)	Group 2: n/N (%)	P-value
3	9/73 (12)	4/43 (9)	0.765
4	29/73 (40)	12/43 (28)	0.185
5	35/73 (48)	27/43 (63)	0.115

Notes: n; number of patients with PC, N; total number of patients.

Abbreviation: PC, positive criteria.

Table 5 Measurement of the dimensions, volume, mass effect, fat density, and lymph nodes of the MP masses in both groups

Criteria	Group 1	Group 2	P-value
Transverse diameter (cm)	10.3	10.97	0.354
Anteroposterior diameter (cm)	4.73	5.02	0.423
Craniocaudal diameter (cm)	11.14	12.5	0.005
Volume (cm^3)	301.8	390.61	0.101
Mass effect, n (%)	57 (78)	36 (84)	0.448
HU MP	−75.99	−66.02	0.001
HU retroperitoneum	−108.78	−102.14	<0.001
Number of lymph nodes	20.2	21.08	0.525
Largest lymph node (cm)	6.94	7.1	0.701

Abbreviations: HU, Hounsfield unit; MP, mesenteric panniculitis.

Table 6 Risk factors for associated malignancy in patients with MP: RR with 95% CIs and ORs

Factor	RR (95% CI)	OR (95% CI)	P-value
Age >60 years	2.228 (1.355, 3.663)	3.668 (1.663, 8.094)	<0.001
MP height >11.5 cm	1.625 (0.964, 2.739)	2.129 (0.97, 4.67)	0.004
MP density > –70 HU	1.714 (1.076, 2.731)	2.429 (1.114, 5.295)	0.02
Presence of pseudocapsule	1.625 (0.964, 2.739)	2.129 (0.97, 4.671)	0.045

Abbreviation: HU, Hounsfield unit; MP, mesenteric panniculitis.