A Case Report of Probable Diagnosis Group of IgG4-related Sclerosing Mesenteritis

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  • YOKOYAMA Daiki
    Department of Surgery, Tokai University Hachioji Hospital
  • TAJIMA Takayuki
    Department of Surgery, Tokai University Oiso Hospital
  • MUKAI Masaya
    Department of Surgery, Tokai University Hachioji Hospital
  • UDA Shuji
    Department of Surgery, Tokai University Hachioji Hospital
  • HIRAIWA Shinichiroh
    Department of Pathology, Tokai University Hachioji Hospital
  • TAJIRI Takuma
    Department of Pathology, Tokai University Hachioji Hospital
  • NOMURA Eiji
    Department of Surgery, Tokai University Hachioji Hospital
  • MAKUUCHI Hiroyasu
    Department of Surgery, Tokai University Hachioji Hospital Department of Gastrointestinal Surgery, Tokai University School of Medicine

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Other Title
  • IgG4関連疾患準確診群と診断された硬化性腸間膜炎の1例
  • 症例 IgG4関連疾患準確診群と診断された硬化性腸間膜炎の1例
  • ショウレイ IgG4 カンレン シッカン ジュンカクシングン ト シンダン サレタ コウカセイ チョウ カンマクエン ノ 1レイ

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Abstract

A 65-year-old otherwise asymptomatic man was found to have localized mesenteric thickening on an ultrasound examination during preoperative evaluation of a left inguinal hernia. Computed tomography also showed a localized mass-like lesion in the mesentery. Other than bulging, the patient had no abdominal symptoms, including no pain or signs of incarceration, related to the inguinal hernia. Therefore, follow-up observation was recommended. However, the abdominal mass continued to enlarge, so 1 year 9 months later, a laparoscopic-assisted partial small bowel resection was performed.<BR>Histopathology showed inflammatory cell infiltration, particularly IgG4-positive plasma cells. Although IgG4-related disease was suspected, serum IgG4 levels were within normal limits. However, a probable diagnosis group of IgG4-related sclerosing mesenteritis was made based on diagnostic criteria. This case involving a mass-like lesion in which a definitive diagnosis was difficult is reported.

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