장간막의 낭성과 고형 종괴의 CT 소견

김윤정,김미영,이주원,서창해,김준미,백승연 대한영상의학회 2006 대한영상의학회지 Vol.55 No.3

CT remains the optimal imaging modality for diagnosing cystic and solid masses in the mesentery. CT may provide important information regarding the lesion's location, size and shape, the presence and thickness of a wall, the presence of septa, calcifications or fat, and the involvement of adjacent structures. Although percutaneous imaging-guided or surgical biopsy is often necessary to guide medical management, analysis of the CT features along with the clinical history may be helpful in differentiating mesenteric masses, including cystic lesions and primary neoplasms arising from the mesenchymal tissues or the secondary metastatic lesions. CT is useful not only for detecting cystic and solid mesenteric masses, but also for helping physicians become familiar with the features of various mesenteric masses for accurate diagnosis and treatment. CT는 장간막의 낭성과 고형 종괴를 진단하는데 최적의 영상 방법이며, 병변의 위치, 크기, 형태, 벽 유무와 두께, 격막, 석회화, 지방조직 유무, 주변 구조물로의 침습 여부를 진단하는 데 중요한 정보를 제공할 수 있다. 영상유도하에 시행하는 경피 또는 수술 생검이 때로는 치료에 필수이나, CT 소견의 분석은 임상과거력과 함께 낭병변과 중배엽(mesenchymal) 기원의 원발 종양 또는 이차종양전이를 감별진단하는 데 도움을 줄 수 있다. CT는 낭과 고형 병변을 발견하는 것 외에도 다양한 장간막 종괴의 소견에 정통하여 정확한 진단과 치료를 제공하는 데 유용하다.

신경섬유종증 1형에서 발생한 상행결장 장간막 총상형 신경섬유종

박선진,최성일,이석환,이길연 대한대장항문학회 2009 Annals of Coloproctolgy Vol.25 No.4

We report a rare case of plexiform neurofibroma involving the ascending colonic mesentery in von Recklinghausen disease. A 20-yr-old male with neurofibromatosis type I was admitted because of abdominal pain, nausea, and vomiting. On physical examination, there were multiple cafe@-au-lait spots over the patient’s entire body. An abdominal computed tomography scan showed a hypodense mass in the ascending colonic mesentery. He underwent a laparoscopic right hemicolectomy with complete excision of the mass. The histological examination showed that the mass consisted of wavy, long-spindled cells, and the immunohistochemical stain for S-100 protein confirmed the mass to be a neurofibroma of the mesentery. The patient had an uneventful postoperative course and no signs of recurrence 16 mo after operation. We report a rare case of plexiform neurofibroma involving the ascending colonic mesentery in von Recklinghausen disease. A 20-yr-old male with neurofibromatosis type I was admitted because of abdominal pain, nausea, and vomiting. On physical examination, there were multiple cafe@-au-lait spots over the patient’s entire body. An abdominal computed tomography scan showed a hypodense mass in the ascending colonic mesentery. He underwent a laparoscopic right hemicolectomy with complete excision of the mass. The histological examination showed that the mass consisted of wavy, long-spindled cells, and the immunohistochemical stain for S-100 protein confirmed the mass to be a neurofibroma of the mesentery. The patient had an uneventful postoperative course and no signs of recurrence 16 mo after operation.

침 생검술로 확진된 전체 장간막을 침범한 림프관종

장원영 ( Won Young Jang ),도민영 ( Min Young Do ),안병찬 ( Byung Chan Ahn ),박명순 ( Myeong Soon Park ),김현아 ( Hyun Ah Kim ),류성열 ( Seong-yeol Ryu ),김상표 ( Sang Pyo Kim ),박건욱 ( Keon Uk Park ) 영남대학교 의과대학 2016 Yeungnam University Journal of Medicine Vol.33 No.2

Lymphangiomas are malformations of the lymphatic system accounting for approximately 5% of all benign tumors in infants and children. Abdominal lymphangiomas are rare, and can arise from either the retroperitoneum, gastrointestinal tract, or the mesentery of the abdominal viscera. Lymphangioma involving the whole mesentery is particularly rare. Most lymphangiomas are detected during infancy or childhood, but intraabdominal lymphangiomas such as mesentery are not found until adulthood. We report here on a patient with uncommon lymphangioma involving the whole mesentery who presented with fever and abdominal pain. This patient is unusual because he was confirmed through core needle biopsy which showed variable sized lymphatic spaces representing a immunoreactive for D2-40 antibody with involvement of the whole mesentery. No cases of mesenteric lymphangioma confirmed preoperatively have been previously reported in Korea.

맹장암과 병발된 장간막 기원의 골수외 형질세포종: 증례 보고

김성규,김용수,김영선,조온구,고병희,임현철,박충기,박동우,박용욱,오영하 대한영상의학회 2005 대한영상의학회지 Vol.52 No.2

골수외 형질세포종은 형질세포의 악성증식이 골 이외의 다른 조직에서 기원하는 드문 질환이며 대부분이 상기도의 점막하층에서 생기는 것으로 알려져 있고 소장간막에서 발생한 경우는 극히 드물다. 저자들은 맹장암과 병발한 소장간막 기원의 골수외 형질세포종 1예를 경험하였기에 이를 보고한다. 초음파와 CT소견은 경계가 좋은 분엽상의 고형 종괴로 내부에 일부 낭성부분과 변연부 석회화를 동반하고 있었으며 동반된 맹장암이 있어 수술 전 방사선학적 진단이 어려웠다. Extramedullary plasmacytoma is a rare disease that is histopathologically defined as a solitary tumor composed of a monoclonal proliferation of cells with plasmacytic differentiation in an extramedullary site. Most of these tumors occur in the submucosa of the upper aerodigestive tract, and they rarely occur in the small bowel mesentery. We report here on a case of extramedullary plasmacytoma of the small bowel mesentery that was in association with a cecal cancer. Abdominal ultrasound and CT revealed a lobulated soft tissue mass with a cystic portion and peripheral calcification. In this case, the preoperative radiological diagnosis was difficult due to accompanying cecal cancer.

장간막의 원발성 악성 섬유성조직구종: 증례 보고

박종헌,연재우,한은미,장석기,강수민,안인옥 대한영상의학회 2007 대한영상의학회지 Vol.57 No.6

A malignant fibrous histiocytoma of the mesentery is rare, and multifocal involvement as a primary tumor is very rare. In this report, a case of malignant fibrous histiocytoma of the mesentery presenting with two masses and multiple peritoneal seeding in a 48-year-old man is described. A physical examination revealed a large, firm, and non-tender mass in the right lower abdomen of the patient. Computed tomography of the lesion revealed a partially, indistinctly marginated and heterogeneously enhancing mass with irregular peritumoral strands in the mesentery of the right lower abdomen, while sonograms of the lesion revealed an ill-defined low-echoic mass. The final pathology demonstrated the presence of a storiform-pleomorphic malignant fibrous histiocytoma. 장간막에 생기는 악성 섬유성조직구종은 드문 원발성 종양이며 다발성으로 생기는 경우는 매우 드물다. 저자들은 최근 발생한 우하복부에 만져지는 종괴를 주소로 내원한 48세 남자 환자에서 장간막에 발생한 두개의 커다란 종괴와 복막 암종증이 동반된 1예를 경험하였기에 초음파, 컴퓨터단층촬영 및 조직 병리소견을 함께 보고하고자 한다. 이 종괴는 초음파에서 경계가 불분명한 저에코로 보였고 컴퓨터단층촬영에서는 부분적으로 경계가 불분명한 불균한 조영증강을 보였으며 주변으로 불규칙한 선상 구조물들이 있었다. 최종 병리 진단은 장간막에서 발생한 다형성 악성 섬유성조직구종이었다.

낭변성을 일으킨 장간막부신경절종:증례 보고

조준식,신경숙,노승무,강대영,Jo, Jun-Sik,Sin, Gyeong-Suk,No, Seung-Mu,Gang, Dae-Yeong 대한영상의학회 2003 대한영상의학회지 Vol.49 No.3

부신외의 부신경절종은 드물며, 대부분 교감신경쇄를 따라 대동맥주위에 위치한 부신경절조직이 풍부한 Zuckerkandl 기관에서 발생한다. 그러나 정상 부신경절조직이 Zuckerkandl 기관의 상부경계가 되는 장간막근에도 존재할 수 있으며, 장간막에서도 매우 드물게 부신경절종이 생길 수 있다.저자들은 장간막에서 기원하여 낭변성을 일으킨 부신경절종 1예의 전산화단층촬영소견과 병리조직소견을 보고한다. Extra-adrenal abdominal paragangliomas are rare. Most arise from the organs of Zuckerkandl, involve large concentrations of paraganglionic tissue, and are located in the para-aortic space along the sympathetic chain. Published reports have, however, described normal paraganglionic tissue at the root of the mesentery which serves as the superior limit of the organs of Zuckerkandl, and mesenteric paraganglioma is very rare. We report a case of paraganglioma with cystic degeneration arising from the mesentery.

장간막에서 발생한 다형태형 지방육종

최진영 ( Jin Young Choi ),김지은 ( Ji Eun Kim ),이승민 ( Seung Min Lee ),강호준 ( Ho Jun Kang ),성지희 ( Ji Hee Sung ),고병성 ( Byung Sung Koh ),박주상 ( Ju Sang Park ),김일동 ( Il Dong Kim ),백소야 ( So Ya Baik ) 대한소화기학회 2015 대한소화기학회지 Vol.65 No.3

Liposarcoma is one of the most common soft tissue sarcomas that occurs in adults and is currently divided into five main subgroups: well-differentiated, myxoid, round cell, pleomorphic, and dedifferentiated. Primary mesenteric liposarcoma is extremely rare, and the treatment strategy is surgical resection with a wide free margin, often followed by radiation and adjuvant chemotherapy if distant metastasis is not detected. A 73-year-old male patient presented with lower abdominal distension. Abdominal CT scan revealed a large homogeneously enhancing mass lesion abutting the sigmoid colon and urinary bladder. At laparotomy, the solid mass measured 28×26×12 cm in size, was well-demarcated, and originated from the mesentery of the middle ileum. It was removed along with some small intestine (ileocecal valve upper 50-150 cm) and ileal mesentery because of adhesion. Histologically, the tumor proved to be pleomorphic liposarcoma. The patient did not undergo any adjuvant treatment following surgery, but he remains disease free until 33 months after surgery. Herein, we report a case of pleomorphic liposarcoma arising from small bowel mesentery. (Korean J Gastroenterol 2015;65:182-185)

Putative Primo-vascular System in Mesentery of Rats

Ping An,Hesheng Luo,Kyang-Hee Bae,Ki-Hoon Eom,이성우,Rongmei Qu,유정선,Zhendong Su,Jingxing Dai,소광섭 사단법인약침학회 2010 Journal of Acupuncture & Meridian Studies Vol.3 No.4

Primo-vessels have been observed in the rat abdominal cavity as floating threadlike structures on and not adhering to fascia-wrapped internal organs. To date their presence, locations, and lengths have been irregular and unpredictable, and their identification not regularly repeatable, thus they have remained a nagging enigma in primo-vascular system research for several years. In this work, locations were found where primo-vessels were regularly present and observed repeatedly. These vessels were not floating or freely movable but lay in a regular position in the mesentery in the abdominal cavity of the rat, being observed between the cecum and small intestine and between the colon and mesentery root. The difference between a lymph vessel and a primo-vessel is described in anatomical and histological aspects. In addition, trypan blue was found to enter primo-vessels through the surrounding membranes and filled spaces between fibers comprising the primovessels. It is conjectured that the previously observed floating primo-vessels had anomalously and irregularly emerged, for some unknown physiological reasons,from primo-vessels normally located in the fascia-like mesentery.

우연히 발견된 장간막의 단중심성 형질세포형 Castleman병 1예: 초음파와 CT 소견 중심으로

김현민,김봉수,정인호,현창림,정승욱,조재민,Kim, Hyun Min,Kim, Bong Soo,Jung, In Ho,Hyun, Chang Lim,Jung, Seung Wook,Jo, Jae Min 제주대학교 의과학연구소 2018 The Journal of Medicine and Life Science Vol.15 No.1

Castleman's disease is a benign lympho-proliferative disorder that commonly occurs in mediastinum. It is known that the disease rarely occurs in mesentery. Most localized abdominal Castleman's diseases are histologically hyaline vascular type. The contrast-enhanced CT in patient with hyaline vascular type Castleman's disease shows a well-defined mass with homogenously intense enhancement. On the other hand, the patient with plasma cell variant has systemic symptoms, but not specific imaging features. We report a unicentric plasma cell variant Castleman's disease in mesentery nearby superior mesenteric artery as presenting a single mass, not accompanied by systemic symptoms with similar characteristics to hyaline vascular type.

The Magnetic Resonance (MR) Imaging Features of Myxoid Liposarcoma Arising from the Mesentery: a Case Report

안태훈,이영환,이규목,김유리,윤권하 대한자기공명의과학회 2017 Investigative Magnetic Resonance Imaging Vol.21 No.4

Primary mesenteric liposarcoma is rare. It is difficult to make an accurate preoperative diagnosis of the myxoid type of liposarcoma by using imaging such as ultrasound or computed tomography (CT) due to the very small amount of fat that is located in the tumor. We report a case of primary myxoid liposarcoma of the mesentery which was difficult to differentiate from other solid mesenteric tumors with a myxoid component such as low grade fibromyxoid sarcoma, myxoid leiomyosarcoma or myxoma. Use of chemical shift magnetic resonance (MR) imaging to detect small fat components and its cystic appearance with solid components on the MR images can be useful to differentiate myxoid liposarcoma from the other mesenteric tumors with a myxoid component.