CT Findings of Cystic and Solid Masses of the Mesentery

CT remains the optimal imaging modality for diagnosing cystic and solid masses in the mesentery. CT may provide important information regarding the lesion? location, size and shape, the presence and thickness of a wall, the presence of septa, calcifications or fat, and the involvement of adjacent structures. Although percutaneous imaging-guided or surgical biopsy is often necessary to guide medical management, analysis of the CT features along with the clinical history may be helpful in differentiating mesenteric masses, including cystic lesions and primary neoplasms arising from the mesenchymal tissues or the secondary metastatic lesions. CT is useful not only for detecting cystic and solid mesenteric masses, but also for helping physicians become familiar with the features of various mesenteric masses for accurate diagnosis and treatment.

CT Findings of Cystic and Solid Masses of the Mesentery

CT remains the optimal imaging modality for diagnosing cystic and solid masses in the mesentery. CT may provide important information regarding the lesion? location, size and shape, the presence and thickness of a wall, the presence of septa, calcifications or fat, and the involvement of adjacent structures. Although percutaneous imaging-guided or surgical biopsy is often necessary to guide medical management, analysis of the CT features along with the clinical history may be helpful in differentiating mesenteric masses, including cystic lesions and primary neoplasms arising from the mesenchymal tissues or the secondary metastatic lesions. CT is useful not only for detecting cystic and solid mesenteric masses, but also for helping physicians become familiar with the features of various mesenteric masses for accurate diagnosis and treatment.

Cystic Lymphangioma Involving the Mesentery and the Retroperitoneum: A Case Report

Cystic lymphangioma is uncommon angiomatous tumor that mainly occurs in the neck. Less than 1% of these tumors affect the mesentery, retroperitoneum and greater omentum. In particular, the cystic lymphangioma involving the mesentery and the retroperitoneum is a rare lesion. We report here on an uncommon case of cystic lymphangioma that presented as a multilocular mass involving the mesentery and the retroperitoneum, and we also present a brief review of the relevant literature.

Mesenteric Paraganglioma with Cystic Degeneration: Case Report

Extra-adrenal abdominal paragangliomas are rare. Most arise from the organs of Zuckerkandl, involve large concentrations of paraganglionic tissue, and are located in the para-aortic space along the sympathetic chain. Published reports have, however, described normal paraganglionic tissue at the root of the mesentery which serves as the superior limit of the organs of Zuckerkandl, and mesenteric paraganglioma is very rare. We report a case of paraganglioma with cystic degeneration arising from the mesentery.

Malignant Gastrointestinal Stromal Tumor of Mesentery Origin: Case Report

A primary tumor of mesenteric origin is rare. We encountered a malignant gastrointestinal stromal tumor (GIST) of mesenteric origin that demonstrated severe necrosis, and report the CT findings and review the literature.

Nonpancreatic Pseudocyst with Fat-Fluid Level: A Case Report

Nonpancreatic pseudocyst is a rare lesion, with a specific fat-fluid level in the cyst. It is found among all age groups. The condition has been previously reported in foreign but not in domestic journals; we now describe one such case.

Ultrasound-guided Biopsy of the Thickened Peritoneal Reflections: Efficacy and Diagnostic Role in the Differential Diagnosis of Peritoneal Tuberculosis and Peritoneal Carcinomatosis

PURPOSE: To evaluate the accuracy and safety of ultrasound-guided biopsy of the thickened peritoneal reflections and to determine the efficacy and diagnostic role of this procedure in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis. MATERIALS AND METHODS: Twenty-seven patients with only mildly thickened (25 mm or less) peritoneal reflections without apparent mass formations, and in whom imaging findings were not diagnostic, underwent ultra-sound-guided biopsy. Five-MHz linear or convex linear array transducers were used for ultrasound guidance,and an automated gun with 18-gauge (n = 23) or 20-gauge (n = 4) needles for tissue sampling. Biopsies were performed on the thickened parietal peritoneum (n = 9), greater omentum (n = 11), and small bowel mesentery (n = 7), and the results were compared with the final diagnosis determined by adiologic/clinical follow-up (n = 17) or laparoscopic biopsy (n = 10). Complications and changes in hemoglobin and hematocrit levels after the procedure were evaluated. RESULTS: Specimens adequate for pathologic examination were obtained in all 27 patients. The histopathologic results were metastatic carcinomatosis (n = 15), peritoneal tuberculosis (n = 8), and chronic granulomatous inflammation (n = 4). Specific pathologic diagnosis was obtained in all patients except the four with chronic granulomatous inflammation. Differentiation between benignancy and malignancy was possible in all patients and the histopathologic specific accuracy rate was 100%. No clinically significant complications were observed. In 24 patients with ascites at the site of the biopsy, transient bleeding was observed immediately after the procedure, but this stopped spontaneously within a few minutes. Post-procedural hemoglobin and hematocrit levels were only minimally lower (mean values of 0.9g/dL and 3.0%, respectively) than pre-procedurally. CONCLUSION: Ultrasound-guided biopsy of thickened peritoneal reflections is a safe and effective diagnostic procedure and is useful in the differential diagnosis of peritoneal tuberculosis and peritoneal carcinomatosis.