DOI: 10.1148/rg.261055151
Benign Fibrous Tumors and Tumorlike Lesions of the Mesentery: Radiologic-Pathologic Correlation1
Angela D. Levy, LTC, MC, USA,
Jordi Rimola, MD,
Anupamjit K. Mehrotra, MD and
Leslie H. Sobin, MD
1 From the Department of Radiologic Pathology (A.D.L.) and Department of Gastrointestinal and Hepatic Pathology (A.K.M., L.H.S.), Armed Forces Institute of Pathology, 6825 16th St NW, Washington, DC 20306-6000; Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md (A.D.L.); and Department of Radiology, UDIAT Diagnostic Center, Sabadell, Spain (J.R.). Received August 1, 2005; revision requested September 13 and received September 28; accepted September 28. All authors have no financial relationships to disclose.
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Figure 1a. Mesenteric fibromatosis in a gravid 27-year-old woman with FAP who had undergone a total proctocolectomy with J-pouch creation 3 years before. (a) Photograph of the resected specimen shows a smoothly marginated mass with a glistening white and tan cut surface that appears slightly whorled. (b) Computed tomographic (CT) scan obtained after intravenous and oral administration of contrast material shows a well-circumscribed mass immediately adjacent to the J-pouch (arrows). The mass of mesenteric fibromatosis has alternating layers of attenuation. Low-attenuation areas represent myxoid stroma and higher-attenuation areas represent collagenous stroma.
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Figure 1b. Mesenteric fibromatosis in a gravid 27-year-old woman with FAP who had undergone a total proctocolectomy with J-pouch creation 3 years before. (a) Photograph of the resected specimen shows a smoothly marginated mass with a glistening white and tan cut surface that appears slightly whorled. (b) Computed tomographic (CT) scan obtained after intravenous and oral administration of contrast material shows a well-circumscribed mass immediately adjacent to the J-pouch (arrows). The mass of mesenteric fibromatosis has alternating layers of attenuation. Low-attenuation areas represent myxoid stroma and higher-attenuation areas represent collagenous stroma.
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Figure 2a. Mesenteric fibromatosis in an 80-year-old woman who had undergone a right hemicolectomy for adenocarcinoma of the cecum. (a) Photograph of the cut surface of the resected specimen shows an ill-defined, infiltrative white mass adherent to adjacent small bowel segments. (b) CT scan with intravenous contrast material enhancement shows a mixed-attenuation mass in the left lower abdomen that has ill-defined medial borders and well-defined borders that contact the adjacent small bowel.
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Figure 2b. Mesenteric fibromatosis in an 80-year-old woman who had undergone a right hemicolectomy for adenocarcinoma of the cecum. (a) Photograph of the cut surface of the resected specimen shows an ill-defined, infiltrative white mass adherent to adjacent small bowel segments. (b) CT scan with intravenous contrast material enhancement shows a mixed-attenuation mass in the left lower abdomen that has ill-defined medial borders and well-defined borders that contact the adjacent small bowel.
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Figure 3a. Histologic features of mesenteric fibromatosis. (a) Photomicrograph (original magnification, x10; hematoxylineosin [H-E] stain) shows fibroblasts in a collagenous stroma. Perivascular microhemorrhages (arrows) are present throughout. (b) Photomicrograph (original magnification, x10; H-E stain) shows numerous thin-walled veins (arrow). (c) Photomicrograph (original magnification, x10; H-E stain) shows keloidal fibers. (d) Photomicrograph (original magnification, x4; H-E stain) shows the lesion (arrows) "melting" into the muscularis propria.
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Figure 3b. Histologic features of mesenteric fibromatosis. (a) Photomicrograph (original magnification, x10; hematoxylineosin [H-E] stain) shows fibroblasts in a collagenous stroma. Perivascular microhemorrhages (arrows) are present throughout. (b) Photomicrograph (original magnification, x10; H-E stain) shows numerous thin-walled veins (arrow). (c) Photomicrograph (original magnification, x10; H-E stain) shows keloidal fibers. (d) Photomicrograph (original magnification, x4; H-E stain) shows the lesion (arrows) "melting" into the muscularis propria.
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Figure 3c. Histologic features of mesenteric fibromatosis. (a) Photomicrograph (original magnification, x10; hematoxylineosin [H-E] stain) shows fibroblasts in a collagenous stroma. Perivascular microhemorrhages (arrows) are present throughout. (b) Photomicrograph (original magnification, x10; H-E stain) shows numerous thin-walled veins (arrow). (c) Photomicrograph (original magnification, x10; H-E stain) shows keloidal fibers. (d) Photomicrograph (original magnification, x4; H-E stain) shows the lesion (arrows) "melting" into the muscularis propria.
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Figure 3d. Histologic features of mesenteric fibromatosis. (a) Photomicrograph (original magnification, x10; hematoxylineosin [H-E] stain) shows fibroblasts in a collagenous stroma. Perivascular microhemorrhages (arrows) are present throughout. (b) Photomicrograph (original magnification, x10; H-E stain) shows numerous thin-walled veins (arrow). (c) Photomicrograph (original magnification, x10; H-E stain) shows keloidal fibers. (d) Photomicrograph (original magnification, x4; H-E stain) shows the lesion (arrows) "melting" into the muscularis propria.
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Figure 4a. Mesenteric fibromatosis in a 48-year-old man who complained of abdominal fullness. (a) Abdominal radiograph obtained with the patient supine shows a large, oval, soft-tissue mass (arrows) in the upper abdomen that displaces the transverse colon inferiorly. (b) CT scan with intravenous and oral contrast material enhancement shows a well-defined, oval, nonenhancing, hypoattenuating mass in the region of the transverse mesocolon.
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Figure 4b. Mesenteric fibromatosis in a 48-year-old man who complained of abdominal fullness. (a) Abdominal radiograph obtained with the patient supine shows a large, oval, soft-tissue mass (arrows) in the upper abdomen that displaces the transverse colon inferiorly. (b) CT scan with intravenous and oral contrast material enhancement shows a well-defined, oval, nonenhancing, hypoattenuating mass in the region of the transverse mesocolon.
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Figure 5a. Mesenteric fibromatosis in a 37-year-old woman who complained of abdominal pain and a palpable abdominal mass. (a) Image from an air contrast barium enema study shows a smoothly marginated mass (arrows) on the inferior surface of the mid-transverse colon. (b) CT scan with intravenous and oral contrast material enhancement shows an oval, partially enhancing mass (arrows) involving the wall of the transverse colon. The epicenter of the mass is in the small bowel mesentery.
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Figure 5b. Mesenteric fibromatosis in a 37-year-old woman who complained of abdominal pain and a palpable abdominal mass. (a) Image from an air contrast barium enema study shows a smoothly marginated mass (arrows) on the inferior surface of the mid-transverse colon. (b) CT scan with intravenous and oral contrast material enhancement shows an oval, partially enhancing mass (arrows) involving the wall of the transverse colon. The epicenter of the mass is in the small bowel mesentery.
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Figure 6a. Mesenteric fibromatosis in a 69-year-old man with nausea, vomiting, and abdominal distention. (a) Image from a barium examination of the small bowel shows a partial obstruction in the small intestine. The transition point (arrow) for the obstruction is in the right midabdomen at the site of the mass effect. The small bowel is draped around and displaced by a rounded mass. (b) Photograph of the unopened, resected specimen show a well-circumscribed mass of mesenteric fibromatosis (*) and the transition point for the small bowel obstruction (arrow). The small bowel is adherent to the mass of mesenteric fibromatosis.
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Figure 6b. Mesenteric fibromatosis in a 69-year-old man with nausea, vomiting, and abdominal distention. (a) Image from a barium examination of the small bowel shows a partial obstruction in the small intestine. The transition point (arrow) for the obstruction is in the right midabdomen at the site of the mass effect. The small bowel is draped around and displaced by a rounded mass. (b) Photograph of the unopened, resected specimen show a well-circumscribed mass of mesenteric fibromatosis (*) and the transition point for the small bowel obstruction (arrow). The small bowel is adherent to the mass of mesenteric fibromatosis.
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Figure 7a. Mesenteric fibromatosis in a 46-year-old man who complained of a left-sided abdominal mass and who had guaiac-positive stools and anemia. (a) Image from a small bowel barium examination shows mass effect in the left lower quadrant and a displaced segment of small intestine (arrows), which has irregularly thickened folds and distorted luminal caliber. Mucosal ulceration is also present. (b) Photograph of the opened, resected specimen shows the mucosal surface of the small bowel with a large defect (*) from the adjacent mass of mesenteric fibromatosis.
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Figure 7b. Mesenteric fibromatosis in a 46-year-old man who complained of a left-sided abdominal mass and who had guaiac-positive stools and anemia. (a) Image from a small bowel barium examination shows mass effect in the left lower quadrant and a displaced segment of small intestine (arrows), which has irregularly thickened folds and distorted luminal caliber. Mucosal ulceration is also present. (b) Photograph of the opened, resected specimen shows the mucosal surface of the small bowel with a large defect (*) from the adjacent mass of mesenteric fibromatosis.
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Figure 8a. Mesenteric fibromatosis in a 42-year-old woman who complained of abdominal distention and pain. (a) Transverse sonogram of the right abdomen shows a well-defined, mixed-echotexture mass. (b) CT scan with intravenous and oral contrast material enhancement shows a well-defined, 18-cm mass centered in the small bowel mesentery. The mass has homogeneous attenuation with the exception of focal low attenuation along its anterior aspect.
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Figure 8b. Mesenteric fibromatosis in a 42-year-old woman who complained of abdominal distention and pain. (a) Transverse sonogram of the right abdomen shows a well-defined, mixed-echotexture mass. (b) CT scan with intravenous and oral contrast material enhancement shows a well-defined, 18-cm mass centered in the small bowel mesentery. The mass has homogeneous attenuation with the exception of focal low attenuation along its anterior aspect.
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Figure 9a. Mesenteric fibromatosis in a 55-year-old woman with a history of hysterectomy and ureteral reimplantation who presented with signs and symptoms of small bowel obstruction. Contiguous CT scans with intravenous and oral contrast material enhancement show a homogeneously attenuating soft-tissue mass (*) in the small bowel mesentery. The mass has ill-defined borders (arrow in a) along its right margin in contact with adjacent small bowel segments.
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Figure 9b. Mesenteric fibromatosis in a 55-year-old woman with a history of hysterectomy and ureteral reimplantation who presented with signs and symptoms of small bowel obstruction. Contiguous CT scans with intravenous and oral contrast material enhancement show a homogeneously attenuating soft-tissue mass (*) in the small bowel mesentery. The mass has ill-defined borders (arrow in a) along its right margin in contact with adjacent small bowel segments.
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Figure 10a. Mesenteric fibromatosis with myxoid stroma in a 46-year-old woman who complained of left upper quadrant and shoulder pain. CT scans (a obtained cephalad to b) with intravenous and oral contrast material enhancement show a hypoattenuating, 18-cm mass (*) in the left upper quadrant that arises from the greater omentum. Gallstones are an incidental finding.
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Figure 10b. Mesenteric fibromatosis with myxoid stroma in a 46-year-old woman who complained of left upper quadrant and shoulder pain. CT scans (a obtained cephalad to b) with intravenous and oral contrast material enhancement show a hypoattenuating, 18-cm mass (*) in the left upper quadrant that arises from the greater omentum. Gallstones are an incidental finding.
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Figure 11a. Mesenteric fibromatosis in a 31-year-old man who complained of epigastric fullness and early satiety. (a) T1-weighted MR image shows a well-defined, low-signal-intensity mass within the small bowel mesentery. (b, c) On T2-weighted images obtained without (b) and with (c) fat suppression, the mass has heterogeneously high signal intensity. (d) T1-weighted fat-suppressed MR image obtained with intravenous gadolinium shows heterogeneous enhancement of the mass.
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Figure 11b. Mesenteric fibromatosis in a 31-year-old man who complained of epigastric fullness and early satiety. (a) T1-weighted MR image shows a well-defined, low-signal-intensity mass within the small bowel mesentery. (b, c) On T2-weighted images obtained without (b) and with (c) fat suppression, the mass has heterogeneously high signal intensity. (d) T1-weighted fat-suppressed MR image obtained with intravenous gadolinium shows heterogeneous enhancement of the mass.
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Figure 11c. Mesenteric fibromatosis in a 31-year-old man who complained of epigastric fullness and early satiety. (a) T1-weighted MR image shows a well-defined, low-signal-intensity mass within the small bowel mesentery. (b, c) On T2-weighted images obtained without (b) and with (c) fat suppression, the mass has heterogeneously high signal intensity. (d) T1-weighted fat-suppressed MR image obtained with intravenous gadolinium shows heterogeneous enhancement of the mass.
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Figure 11d. Mesenteric fibromatosis in a 31-year-old man who complained of epigastric fullness and early satiety. (a) T1-weighted MR image shows a well-defined, low-signal-intensity mass within the small bowel mesentery. (b, c) On T2-weighted images obtained without (b) and with (c) fat suppression, the mass has heterogeneously high signal intensity. (d) T1-weighted fat-suppressed MR image obtained with intravenous gadolinium shows heterogeneous enhancement of the mass.
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Figure 12a. Mesenteric fibromatosis in a 57-year-old man with long-standing Crohn disease and a history of prior right hemicolectomy who presented with abdominal pain. (a) CT scan with intravenous contrast material enhancement shows an ill-defined mass (arrow) in the small bowel mesentery. Multiple small mesenteric lymph nodes are present. (b–d) MR images show that the mass has low signal intensity with a fast spoiled gradient-echo nonenhanced pulse sequence (arrow in b), has heterogeneously high signal intensity with T2 weighting (arrow in c), and enhances with a fat-saturated, fast spoiled gradient-echo pulse sequence and intravenous gadolinium (arrow in d).
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Figure 12b. Mesenteric fibromatosis in a 57-year-old man with long-standing Crohn disease and a history of prior right hemicolectomy who presented with abdominal pain. (a) CT scan with intravenous contrast material enhancement shows an ill-defined mass (arrow) in the small bowel mesentery. Multiple small mesenteric lymph nodes are present. (b–d) MR images show that the mass has low signal intensity with a fast spoiled gradient-echo nonenhanced pulse sequence (arrow in b), has heterogeneously high signal intensity with T2 weighting (arrow in c), and enhances with a fat-saturated, fast spoiled gradient-echo pulse sequence and intravenous gadolinium (arrow in d).
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Figure 12c. Mesenteric fibromatosis in a 57-year-old man with long-standing Crohn disease and a history of prior right hemicolectomy who presented with abdominal pain. (a) CT scan with intravenous contrast material enhancement shows an ill-defined mass (arrow) in the small bowel mesentery. Multiple small mesenteric lymph nodes are present. (b–d) MR images show that the mass has low signal intensity with a fast spoiled gradient-echo nonenhanced pulse sequence (arrow in b), has heterogeneously high signal intensity with T2 weighting (arrow in c), and enhances with a fat-saturated, fast spoiled gradient-echo pulse sequence and intravenous gadolinium (arrow in d).
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Figure 12d. Mesenteric fibromatosis in a 57-year-old man with long-standing Crohn disease and a history of prior right hemicolectomy who presented with abdominal pain. (a) CT scan with intravenous contrast material enhancement shows an ill-defined mass (arrow) in the small bowel mesentery. Multiple small mesenteric lymph nodes are present. (b–d) MR images show that the mass has low signal intensity with a fast spoiled gradient-echo nonenhanced pulse sequence (arrow in b), has heterogeneously high signal intensity with T2 weighting (arrow in c), and enhances with a fat-saturated, fast spoiled gradient-echo pulse sequence and intravenous gadolinium (arrow in d).
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Figure 13a. Mesenteric, retroperitoneal, and pelvic fibromatosis in a 28-year-old woman with FAP who had undergone a subtotal colectomy. CT scans with intravenous contrast material enhancement (obtained at successively caudal levels) show an infiltrating mass in the mesentery and retroperitoneum (arrows). The mass encases the right ureter, in which a stent had been placed (bright spot in c) and infiltrates adjacent small bowel segments. Right hydronephrosis is seen.
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Figure 13b. Mesenteric, retroperitoneal, and pelvic fibromatosis in a 28-year-old woman with FAP who had undergone a subtotal colectomy. CT scans with intravenous contrast material enhancement (obtained at successively caudal levels) show an infiltrating mass in the mesentery and retroperitoneum (arrows). The mass encases the right ureter, in which a stent had been placed (bright spot in c) and infiltrates adjacent small bowel segments. Right hydronephrosis is seen.
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Figure 13c. Mesenteric, retroperitoneal, and pelvic fibromatosis in a 28-year-old woman with FAP who had undergone a subtotal colectomy. CT scans with intravenous contrast material enhancement (obtained at successively caudal levels) show an infiltrating mass in the mesentery and retroperitoneum (arrows). The mass encases the right ureter, in which a stent had been placed (bright spot in c) and infiltrates adjacent small bowel segments. Right hydronephrosis is seen.
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Figure 14a. Histologic features of sclerosing mesenteritis. (a) Photomicrograph (original magnification, x10; H-E stain) shows fat necrosis, sclerosing fibrosis (*), and inflammatory cells (arrow). (b) Photomicrograph (original magnification, x16; H-E stain) shows the inflammatory infiltrate (arrowheads) extending to the edge of the muscularis propria. The inflammatory process does not extend into the muscularis propria. (c) Photomicrograph (original magnification, x40; H-E stain) shows dense sclerosis, typical of sclerosing mesenteritis, with an accompanying inflammatory infiltrate. (d) Photomicrograph (original magnification, x16; H-E stain) shows the dense sclerosis, which abuts the loose myxomatous stroma (*) and forms a pseudocapsule.
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Figure 14b. Histologic features of sclerosing mesenteritis. (a) Photomicrograph (original magnification, x10; H-E stain) shows fat necrosis, sclerosing fibrosis (*), and inflammatory cells (arrow). (b) Photomicrograph (original magnification, x16; H-E stain) shows the inflammatory infiltrate (arrowheads) extending to the edge of the muscularis propria. The inflammatory process does not extend into the muscularis propria. (c) Photomicrograph (original magnification, x40; H-E stain) shows dense sclerosis, typical of sclerosing mesenteritis, with an accompanying inflammatory infiltrate. (d) Photomicrograph (original magnification, x16; H-E stain) shows the dense sclerosis, which abuts the loose myxomatous stroma (*) and forms a pseudocapsule.
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Figure 14c. Histologic features of sclerosing mesenteritis. (a) Photomicrograph (original magnification, x10; H-E stain) shows fat necrosis, sclerosing fibrosis (*), and inflammatory cells (arrow). (b) Photomicrograph (original magnification, x16; H-E stain) shows the inflammatory infiltrate (arrowheads) extending to the edge of the muscularis propria. The inflammatory process does not extend into the muscularis propria. (c) Photomicrograph (original magnification, x40; H-E stain) shows dense sclerosis, typical of sclerosing mesenteritis, with an accompanying inflammatory infiltrate. (d) Photomicrograph (original magnification, x16; H-E stain) shows the dense sclerosis, which abuts the loose myxomatous stroma (*) and forms a pseudocapsule.
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Figure 14d. Histologic features of sclerosing mesenteritis. (a) Photomicrograph (original magnification, x10; H-E stain) shows fat necrosis, sclerosing fibrosis (*), and inflammatory cells (arrow). (b) Photomicrograph (original magnification, x16; H-E stain) shows the inflammatory infiltrate (arrowheads) extending to the edge of the muscularis propria. The inflammatory process does not extend into the muscularis propria. (c) Photomicrograph (original magnification, x40; H-E stain) shows dense sclerosis, typical of sclerosing mesenteritis, with an accompanying inflammatory infiltrate. (d) Photomicrograph (original magnification, x16; H-E stain) shows the dense sclerosis, which abuts the loose myxomatous stroma (*) and forms a pseudocapsule.
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Figure 15a. Sclerosing mesenteritis in a 73-year-old man with abdominal pain, nausea, vomiting, and diarrhea. (a) Image from a small bowel barium examination shows tethered segments of small intestine that are fixed in the midabdomen. There is mild dilatation of a segment of small bowel and irregular fold thickening (arrowheads). (b) CT scan with intravenous and oral contrast material enhancement shows a partially calcified mass at the root of the small bowel mesentery. Fibrous strands radiate from the mass and fix portions of the small bowel. (c) Photograph of the cut surface of the resected specimen shows the multifocal firm, yellow mass (arrows) in the root of the small bowel mesentery. The mesenteric fat and adjacent bowel are retracted.
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Figure 15b. Sclerosing mesenteritis in a 73-year-old man with abdominal pain, nausea, vomiting, and diarrhea. (a) Image from a small bowel barium examination shows tethered segments of small intestine that are fixed in the midabdomen. There is mild dilatation of a segment of small bowel and irregular fold thickening (arrowheads). (b) CT scan with intravenous and oral contrast material enhancement shows a partially calcified mass at the root of the small bowel mesentery. Fibrous strands radiate from the mass and fix portions of the small bowel. (c) Photograph of the cut surface of the resected specimen shows the multifocal firm, yellow mass (arrows) in the root of the small bowel mesentery. The mesenteric fat and adjacent bowel are retracted.
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Figure 15c. Sclerosing mesenteritis in a 73-year-old man with abdominal pain, nausea, vomiting, and diarrhea. (a) Image from a small bowel barium examination shows tethered segments of small intestine that are fixed in the midabdomen. There is mild dilatation of a segment of small bowel and irregular fold thickening (arrowheads). (b) CT scan with intravenous and oral contrast material enhancement shows a partially calcified mass at the root of the small bowel mesentery. Fibrous strands radiate from the mass and fix portions of the small bowel. (c) Photograph of the cut surface of the resected specimen shows the multifocal firm, yellow mass (arrows) in the root of the small bowel mesentery. The mesenteric fat and adjacent bowel are retracted.
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Figure 16a. Sclerosing mesenteritis in a 70-year-old man who complained of abdominal pain and distention. (a, b) CT scans (a obtained cephalad to b) with intravenous contrast material enhancement show a partial small bowel obstruction and a fixed segment of small intestine in the midabdomen that radiates around a spiculated, partially calcified mass in the small bowel mesentery (arrow). Radiating bands of fibrosis extend from the mass to the small bowel. (c) Intraoperative photograph shows nodules (straight arrow) and thickening (curved arrow) at the root of the small bowel mesentery.
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Figure 16b. Sclerosing mesenteritis in a 70-year-old man who complained of abdominal pain and distention. (a, b) CT scans (a obtained cephalad to b) with intravenous contrast material enhancement show a partial small bowel obstruction and a fixed segment of small intestine in the midabdomen that radiates around a spiculated, partially calcified mass in the small bowel mesentery (arrow). Radiating bands of fibrosis extend from the mass to the small bowel. (c) Intraoperative photograph shows nodules (straight arrow) and thickening (curved arrow) at the root of the small bowel mesentery.
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Figure 16c. Sclerosing mesenteritis in a 70-year-old man who complained of abdominal pain and distention. (a, b) CT scans (a obtained cephalad to b) with intravenous contrast material enhancement show a partial small bowel obstruction and a fixed segment of small intestine in the midabdomen that radiates around a spiculated, partially calcified mass in the small bowel mesentery (arrow). Radiating bands of fibrosis extend from the mass to the small bowel. (c) Intraoperative photograph shows nodules (straight arrow) and thickening (curved arrow) at the root of the small bowel mesentery.
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Figure 17a. Incidental discovery of sclerosing mesenteritis in a 61-year-old man who was evaluated with CT before undergoing a aorta-femoral bypass graft procedure. CT scans (obtained at successively caudal levels) with intravenous and oral contrast material enhancement show a 7.5-cm, partially calcified, well-defined mass (arrows) in the transverse mesocolon. The mass extends to the mesenteric border of the transverse colon.
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Figure 17b. Incidental discovery of sclerosing mesenteritis in a 61-year-old man who was evaluated with CT before undergoing a aorta-femoral bypass graft procedure. CT scans (obtained at successively caudal levels) with intravenous and oral contrast material enhancement show a 7.5-cm, partially calcified, well-defined mass (arrows) in the transverse mesocolon. The mass extends to the mesenteric border of the transverse colon.
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Figure 18a. Cystlike sclerosing mesenteritis in a 25-year-old woman who complained of left flank pain and a 16-pound weight gain. CT scans (a obtained cephalad to b) with intravenous and oral contrast material enhancement show a well-defined, hypoattenuating retroperitoneal mass (*) with a cystic appearance caused by loose myxomatous stroma. The mass has a pseudocapsule (arrows) of dense fibrous tissue.
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Figure 18b. Cystlike sclerosing mesenteritis in a 25-year-old woman who complained of left flank pain and a 16-pound weight gain. CT scans (a obtained cephalad to b) with intravenous and oral contrast material enhancement show a well-defined, hypoattenuating retroperitoneal mass (*) with a cystic appearance caused by loose myxomatous stroma. The mass has a pseudocapsule (arrows) of dense fibrous tissue.
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Figure 19a. Histologic features of inflammatory pseudotumor. Photomicrographs (H-E stain) obtained at two magnifications (a, x20; b, x40) show spindle cells with a lymphoplasmacytic infiltrate.
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Figure 19b. Histologic features of inflammatory pseudotumor. Photomicrographs (H-E stain) obtained at two magnifications (a, x20; b, x40) show spindle cells with a lymphoplasmacytic infiltrate.
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Figure 20a. Inflammatory pseudotumor in an 11-year-old girl with a 2-month history of fatigue and abdominal pain radiating to the left shoulder. Intravenous and oral contrast-enhanced CT scans (a obtained cephalad to b) with intravenous and oral contrast material enhancement show an ill-defined, infiltrative mass (straight arrows in a and b) in the greater omentum. The mass extends into the small bowel mesentery (curved arrow in b) and infiltrates adjacent bowel segments.
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Figure 20b. Inflammatory pseudotumor in an 11-year-old girl with a 2-month history of fatigue and abdominal pain radiating to the left shoulder. Intravenous and oral contrast-enhanced CT scans (a obtained cephalad to b) with intravenous and oral contrast material enhancement show an ill-defined, infiltrative mass (straight arrows in a and b) in the greater omentum. The mass extends into the small bowel mesentery (curved arrow in b) and infiltrates adjacent bowel segments.
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Figure 21a. Inflammatory pseudotumor in a 68-year-old woman who complained of abdominal pain and progressive weight loss. CT scans (a obtained caudad to b) with intravenous and oral contrast material enhancement show a homogeneous soft-tissue mass (arrows) in the small bowel mesentery that has ill-defined margins.
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Figure 21b. Inflammatory pseudotumor in a 68-year-old woman who complained of abdominal pain and progressive weight loss. CT scans (a obtained caudad to b) with intravenous and oral contrast material enhancement show a homogeneous soft-tissue mass (arrows) in the small bowel mesentery that has ill-defined margins.
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Figure 22a. Solitary fibrous tumor of the peritoneum arising from a peritoneal reflection that forms the pre-vesical space in a 61-year-old man who complained of difficulty with urination. (a) Longitudinal and transverse sonograms show a well-defined mass with homogeneous medium echotexture anterior to the bladder. (b) Doppler sonogram shows central vascularity within the mass. (c, d) Contrast-enhanced CT scans show marked enhancement within the mass during the early portal venous phase of contrast enhancement (arrow in c) mixed with areas of nonenhancement. There is loss of contrast enhancement during the delayed phase of enhancement (arrow in d). Prostatic enlargement is shown along the posterior aspect of the bladder. (Case courtesy of Jordi Puig, MD, UDIAT-CD, Corporacioó Parc Taulí, Sabadell, Spain.)
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Figure 22b. Solitary fibrous tumor of the peritoneum arising from a peritoneal reflection that forms the pre-vesical space in a 61-year-old man who complained of difficulty with urination. (a) Longitudinal and transverse sonograms show a well-defined mass with homogeneous medium echotexture anterior to the bladder. (b) Doppler sonogram shows central vascularity within the mass. (c, d) Contrast-enhanced CT scans show marked enhancement within the mass during the early portal venous phase of contrast enhancement (arrow in c) mixed with areas of nonenhancement. There is loss of contrast enhancement during the delayed phase of enhancement (arrow in d). Prostatic enlargement is shown along the posterior aspect of the bladder. (Case courtesy of Jordi Puig, MD, UDIAT-CD, Corporacioó Parc Taulí, Sabadell, Spain.)
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Figure 22c. Solitary fibrous tumor of the peritoneum arising from a peritoneal reflection that forms the pre-vesical space in a 61-year-old man who complained of difficulty with urination. (a) Longitudinal and transverse sonograms show a well-defined mass with homogeneous medium echotexture anterior to the bladder. (b) Doppler sonogram shows central vascularity within the mass. (c, d) Contrast-enhanced CT scans show marked enhancement within the mass during the early portal venous phase of contrast enhancement (arrow in c) mixed with areas of nonenhancement. There is loss of contrast enhancement during the delayed phase of enhancement (arrow in d). Prostatic enlargement is shown along the posterior aspect of the bladder. (Case courtesy of Jordi Puig, MD, UDIAT-CD, Corporacioó Parc Taulí, Sabadell, Spain.)
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Figure 22d. Solitary fibrous tumor of the peritoneum arising from a peritoneal reflection that forms the pre-vesical space in a 61-year-old man who complained of difficulty with urination. (a) Longitudinal and transverse sonograms show a well-defined mass with homogeneous medium echotexture anterior to the bladder. (b) Doppler sonogram shows central vascularity within the mass. (c, d) Contrast-enhanced CT scans show marked enhancement within the mass during the early portal venous phase of contrast enhancement (arrow in c) mixed with areas of nonenhancement. There is loss of contrast enhancement during the delayed phase of enhancement (arrow in d). Prostatic enlargement is shown along the posterior aspect of the bladder. (Case courtesy of Jordi Puig, MD, UDIAT-CD, Corporacioó Parc Taulí, Sabadell, Spain.)
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Copyright © 2006 by the Radiological Society of North America.
