How is Mesenteric Lymphoma Diagnosed?

This entry looks at what is sometimes referred to as mesenteric lymphoma, also referred to as non-Hodgkin's lymphoma of the mesentery, one of the categorical types of lymphoma. 'Lymphoma' is an umbrella term that loosely refers to several dozen independent categorical types and subtypes of cancers of the lymphatic system.

What does 'Mesenteric' Mean?

The term 'mesenteric' or mesentery refers to folds of tissue that attach organs to the body wall. Relevant to this article, the small bowel mesentery connects the small intestine to the abdominal wall. A variety of nerves, as well as blood and lymph vessels pass through here. Additionally, the mesenteric lymph nodes, sometimes involved in various lymphomas, are located here.

How is Mesenteric Lymphoma Diagnosed?

When the mesentery is imaged by way of CT or ultrasound, a very telling image will appear if the patient is suffering from mesenteric lymphoma. This is called the 'Sandwich sign'. What this means is that there are confluent mesenteric lymph nodes that represent the two half buns of a sandwich. The 'filling' is made up of tubular mesenteric vessels and perivascular fat.

Symptoms of mesenteric lymphomas are not quite the same as we see in other lymphomas, largely because of the region itself. Thus if and when symptoms do appear from such a tumor, they tend to cause intestinal problems such as constipation, as well as diffuse abdominal pain and occasionally nausea and/or vomiting.

Mesenteric lymphomas can become quite large and yet not cause any symptoms. In fact, these lymphomas are often found on accident, when doctors or surgeons are looking for something else. In one noted case, a mesenteric tumor was discovered in a completely asymptomatic patient that measured a shocking 18x14x10 cm.

How is Mesenteric Lymphoma Treated and What is the Prognosis?

To reiterate, mesenteric tumors or masses are typically not found unless by mistake, and can, therefore, grow quite large. Surgical resection of the tumor is a common treatment, followed by adjuvant chemotherapy.

It is difficult to say with any broad accuracy what kind of prognosis can be expected with mesenteric lymphoma, and that is because the disease itself is so rare, and so little research has been done specifically on this disease, even retrospectively.

Sources: Salemis NS et al. Diffuse large B cell lymphoma of the mesentery: an unusual presentation and review of the literature. J Gastrointest Cancer. 2009;40(3-4):79-82. Medscape: Mesenteric Tumors. Medappil N, Reghukumar R. Sandwich sign in mesenteric lymphoma. J Can Res Ther 2010;6:403-4
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