Document Detail

Are tumefactive lesions classified as sclerosing mesenteritis a subset of IgG4-related sclerosing disorders?
MedLine Citation:
PMID:  18682417     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The relationship between tumefactive lesions classified as sclerosing mesenteritis and IgG4-related sclerosing disorders (eg, lymphoplasmacytic sclerosing pancreatitis/autoimmune pancreatitis) remains uncertain. AIMS: To review lesions coded as "sclerosing mesenteritis" for findings in keeping with IgG4-related sclerosing disorders. METHODS: Inclusion in the study required available paraffin blocks for IgG4 staining and documentation of a mass lesion. RESULTS: A total of nine mesenteric lesions (3-14 cm) were identified in 6 male and 3 female patients. On H&E-stained sections, all were characterised as loosely marginated fibroinflammatory processes with variable amounts of fat necrosis. Lymphocytic venulitis/phlebitis was identified in 8 of 9 cases. IgG and IgG4 expression in lesional plasma cells was assessed by immunohistochemistry. IgG4-positive plasma cells were counted in the areas of greatest density in >or=3 high power fields (HPFs). The highest number per HPF was recorded and a score assigned based on the following scale: <5/HPF, none/minimal; 5-10/HPF, mild; 11-30/HPF, moderate; >30/HPF, marked. The relative proportion of IgG4-reactive plasma cells to total IgG-positive plasma cells was assessed. IgG4-reactive plasma cells ranged from 0 to >100 in the most dense zones (3 cases, none/minimal; 4 cases, moderate; 2 cases, marked). CONCLUSIONS: Although this study is limited by small numbers, findings suggest that some tumefactive lesions regarded as sclerosing mesenteritis may be a subset of IgG4-related sclerosing disorders.
T S Chen; E A Montgomery
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Publication Detail:
Type:  Journal Article     Date:  2008-08-04
Journal Detail:
Title:  Journal of clinical pathology     Volume:  61     ISSN:  1472-4146     ISO Abbreviation:  J. Clin. Pathol.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-29     Completed Date:  2008-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376601     Medline TA:  J Clin Pathol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1093-7     Citation Subset:  AIM; IM    
Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21231, USA.
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MeSH Terms
Arteries / immunology,  pathology
Cell Count
Immunoglobulin G / analysis
Lymphocytes / immunology,  pathology
Middle Aged
Panniculitis, Peritoneal / immunology,  pathology*
Phlebitis / immunology,  pathology
Plasma Cells / immunology,  pathology*
Staining and Labeling
Veins / immunology,  pathology
Reg. No./Substance:
0/Immunoglobulin G

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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