Journal of Pathology and Translational Medicine

Case Study

Heterotopic mesenteric ossification: a report of two cases: Hisham F. Bahmad, Olga Lopez, Tyson Sutherland, Marisa Vinas, Kfir Ben-David, Lydia Howard, Robert Poppiti, Sarah Alghamdi; J Pathol Transl Med. 2022;56(5):294-300. Published online September 13, 2022; DOI: https://doi.org/10.4132/jptm.2022.07.23

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Abstract PDF: Heterotopic mesenteric ossification (HMO) is abnormal bone formation in tissues which usually do not undergo ossification. There are approximately 75 cases reported worldwide. We present two cases of HMO. The first case is that of a 39-year-old man who presented with abdominal pain and a computerized tomography scan of the abdomen and pelvis revealed an apple core lesion resulting in small bowel obstruction. The second case is that of a 36-year-old woman who presented 2 months after undergoing robotic gastric sleeve resection complaining of weakness and emesis. An esophagogram revealed kinking at the distal esophagus. Surgical resection was performed in both, yielding the diagnosis of HMO. There are various theories as to the pathophysiology of HMO, but no clearly defined mechanism has been established. Management should be conservative whenever possible to prevent further ossification with subsequent surgical intervention.

Case Reports

Primary Monophasic Synovial Sarcoma Arising in the Mesentery: Case Report of an Extremely Rare Mesenteric Sarcoma Confirmed by Molecular Detection of a SYT-SSX2 Fusion Transcript: Han Suk Ryu, Ilyeong Heo, Jae Soo Koh, Sung-Ho Jin, Hye Jin Kang, Soo Youn Cho; Korean J Pathol. 2012;46(2):187-191. Published online April 25, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.2.187

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3 Crossref

Synovial sarcoma arises in the para-articular tissues, and it can also occur in various unexpected sites. We report a rare case of primary monophasic synovial sarcoma (MSS) arising in the mesentery. A 59-year-old man presented with a palpable abdominal mass. On microscopic examination, the entire tumor comprised a dense proliferation of the spindle cells without epithelial components. The tumor cells were positive for transducin-like enhancer of split 1, bcl-2, epithelial membrane antigen and CD99 but negative for CD34, CD117, alpha-smooth muscle actin, cytokeratin, and calretinin on immunohistochemistry. The reverse transcriptase-polymerase chain reaction revealed a single 151-bp fragment representing the SYT-SSX2 fusion transcript. Because mesenteric MSS is extremely rare and many cases display histologic findings that overlap with those of more frequently involved tumors such as hemangiopericytoma and gastrointestinal stromal tumor, there is a chance of making an incorrect diagnosis that can result in an inappropriate treatment.

Citations

Citations to this article as recorded by

A case of primary mesenteric synovial sarcoma: a challenging presentation
Nihed Abdessayed, Malek Barka, Samiha Mabrouk, Zeineb Nfikha, Zeineb Maatoug, Yosra Fejji, Mohamed Salah Jarrar, Sabri Youssef, Moncef Mokni
Surgical Case Reports.2023;[Epub] CrossRef
Giant solitary fibrous tumor of the pelvis: A case report and review of literature
Gerardo Palmieri, Carmine Grassi, Luigi Conti, Filippo Banchini, Maria Diletta Daccò, Gaetano M. Cattaneo, Patrizio Capelli
International Journal of Surgery Case Reports.2020; 77: S52. CrossRef
Tumeur neuroectodermique gastro-intestinale (GNET) : à propos d’un cas de tumeur du grêle avec métastases hépatiques
Thibault Kervarrec, Claire Lecointre, Rémy Kerdraon, Guido Bens, Arnaud Piquard, Patrick Michenet
Annales de Pathologie.2015; 35(6): 506. CrossRef

Inflammatory Myofibroblastic Tumor of the Mesentery: A case report.: Sung Jig Lim, Gou Young Kim, Jae Hoon Park, Youn Wha Kim, Yong Koo Park, Ju Hie Lee, Moon Ho Yang; Korean J Pathol. 1999;33(9):729-732.

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Abstract PDF: Inflammatory myofibroblastic tumor or inflammatory pseudotumor is characterized by spindle cell proliferation with inflammatory cell infiltration, predominantly plasma cells and lymphocytes. We have experienced a case of inflammatory myofibroblastic tumor of the mesentery in a 57-year-old male patient with intermittent abdominal pain. On computer tomography, a well demarcated mass was seen in the mesenteric side of the ascending colon. Right hemicolectomy was performed under the impression of the metastatic tumor of lymph nodes. Grossly, a rather well-circumscribed gray white mass was noted in the mesentery of the ascending colon. Microscopically, the lesion consisted of plump spindle cells and accompanying inflammatory cellular infiltrates. The spindle cells were positive for vimentin.

Original Article

Fine Needle Aspiration Cytology of Inflammatory Myofibroblastic Tumor in Mesentery: A Case Report.: Hyun Jin Son, Joo Heon Kim, Woo Sung Moon, Myoung Jae Kang, Ho Yeul Choi; Korean J Cytopathol. 2000;11(1):35-40.

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Abstract PDF: Since inflammatory myofibroblastic tumor was initially recognized in the lung, this tumor has been described in other extrapulmonary sites. In spite of relatively uniform histologic findings in various organs, a rarity in extrapulmonary sites and highly vascular characteristics frequently lead to a misdiagnosis in preoperative radiology and fine needle aspiration cytology. We present a case of inflammatory myofibro blastic tumor occurring in the mesentery of a 4-month-old girl. Fine needle aspira tion cytology smear disclosed characteristic spindle cells intermixed with prominent mature plasma cells and lymphocytes. According to the immunohistochemical staining, we recognized that the intervening spindle cells are myofibroblasts which have reactivity for the both actin and vimentin.

Case Reports

Kikuchi's Disease of the Mesenteric Lymph Nodes Presenting as Acute Appendicitis.: Kyueng Whan Min, Ki Seok Jang, Si Hyong Jang, Young Soo Song, Woong Na, Soon Young Song, Seung Sam Paik; Korean J Pathol. 2007;41(1):44-46.

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Abstract PDF: Kikuchi's disease is a benign self-limiting necrotizing lymphadenitis that occurs most commonly in young women, and is usually found in the cervical lymph nodes. When there is an unusual location of involved lymph nodes, the diagnosis can be difficult. We recently treated a patient with Kikuchi's disease who had ileocecal mesenteric lymph node involvement; the patient presented with symptoms of acute appendicitis in an 11-year old boy. Although mesenteric lymph node involvement of Kikuchi's disease is very rare, Kikuchi's disease should be added to the differential diagnosis of acute appendicitis in patients with enlarged ileocecal mesenteric lymph nodes on radiological evaluation.

Heterotopic Mesenteric Ossification: A Case Report.: Hoon Kyu Oh, Jong Yup Bae; Korean J Pathol. 2006;40(1):70-72.

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Abstract PDF: Heterotopic mesenteric ossification is a very rare reactive lesion in the small bowel mesentery, and it is related with trauma or surgical operation. It is pathologically characterized by well formed bone trabeculae and prominent osteoblastic rimming and is clinically related to rapid and recurrent bowel obstruction symptoms. This unusual reactive process shares many clinical and pathologic features with myositis ossificans. We report here on a rare case of heterotopic mesenteric ossification in 28-year-old man who underwent a delayed small bowel resection 15 days after trauma.

Mesenteric Cystic Lymphangioma with Sustained Abdominal Pain : Report of a case.: Gyeong Hoon Kang, Yong Il Kim, Woo Ho Kim, In Sung Song, Kyoo Wan Choi; Korean J Pathol. 1991;25(5):488-490.

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Abstract: A case of cystic lymphangioma of the mesentery with severe and persistent abdominal pain in a 22-year-old man is presented. The cyst was filled with chylous fluid. Microscopically, numerous nerve bundles were incorporated within the lymphangiomatous walls, and some protruded into the lumen. The above findings lead to a suggestion that mesenteric lymphangioma may differ from those in the other sites by its abundance of incorporation of nerve bundles into the lymphangiomatous walls, and that increase of tumor size by intracystic accumulation of chylous fluid may subsequently result in increase of intraluminal pressure to compress the nerve bundles with which abdominal pain is much enhanced.

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