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British Journal of Radiology (2006) 79, 37-43
© 2006 British Institute of Radiology
doi: 10.1259/bjr/29320216
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Mesenteric panniculitis in oncologic patients: PET-CT findings

R Zissin, MD1,2,3, U Metser, MD1,3, D Hain, MD4 and E Even-Sapir, MD, PhD1,3

1 Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, and the 2 Department of Diagnostic Imaging, Sapir Medical Center, Kfar Saba, both affiliated to the 3 Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, and 4 Nuclear Medicine Institute, Shaare Zedek Medical Center, Jerusalem, Israel


Figure 1
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  		Figure 1. CT findings of mesenteric panniculitis (MP). Non-enhanced abdominal CT at the mid-abdomen shows a well-defined, inhomogeneous fatty lesion, with higher attenuation than the normal retroperitoneal fat, confined by a highly-attenuated stripe representing a tumoural pseudocapsule (thick arrows), with an engorged mesenteric vessel and scattered discrete nodules of soft-tissue density, some of which are engulfed by a hypodense fatty halo (thin arrow).

 

Figure 2
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  		Figure 2. A 50-year-old man with follicular lymphoma: mesenteric panniculitis (MP) with meseneteric tumoural involvement before and after a favourable response to chemotherapy. (a) A fused PET/CT image shows increased 18F-FDG uptake in an 8 mm nodule (dashed arrow) in the background of MP (arrows). The latter appears as a mesenteric mass of inhomogeneous fatty tissue containing scattered soft-tissue nodules which are not 18FDG-avid. (b) PET/CT images at diagnosis (top images) and following chemotherapy (lower images) show regression in size of the nodule and disappearance of 18FDG uptake (arrows). No change is seen in the other findings of the MP.

 

Figure 3
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  		Figure 3. A 76-year-old man with non-Hodgkin's lymphoma (NHL): mesenteric panniculitis (MP) with meseneteric tumoural involvement with disease progression. PET/CT images at diagnosis (top images) and 4 months later (lower images): (a) At the mid-abdomen typical findings of MP with no 18F-FDG uptake are seen, stable on F/U. (b) More caudally, increased 18F-FDG uptake is detected at diagnosis within a 1.2 cm x 1.5 cm mesenteric nodule (SUV – 13.2) (arrows). On F/U the hypermetabolic node, most likely involved with lymphoma, enlarged to 3.8 cm x 4 cm with increasing 18F-FDG uptake (SUV – 18.8) (arrows).

 

Figure 4
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  		Figure 4. A 78-year-old man with diffuse B cell lymphoma and co-existing mesenteric panniculitis (MP). A fused PET/CT image shows typical findings of MP, including inhomogeneous fatty density mass with well-defined nodules of soft-tissue density, confined by a pseudocapsule (arrows), without 18F-FDG uptake. The findings remain stable on a F/U PET/CT, 5 months later, with no clinical evidence of active lymphoma.

 




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