[Mesenteric lipodystrophy]

Abstract

Mesenterial lipodystrophy is characterized macroscopically by a light yellow nodular or diffuse thickening of the mesenterium. Microscopically, infiltration of the mesenteric adipose tissue with lipid containing macrophages predominates. Mesenterial lipodystrophy is a rather common finding in autopsies. To obtain more information about the frequency and the nature of these alterations, the mesenterium of all adult autopsies during a period of 6 months was investigated. 9 out of 712 autopsies (1.26%) showed mesenterial lipodystrophy. In these cases as well, the typical macroscopic findings were nodular or diffuse mesenterial thickening partly discoloured to light yellow or orange-brown. Microscopically, infiltration of the adipose tissue with foamy cells predominated. Monocytic cells, and occasionally fibrosis, were also found. Retrospective study of the case histories gave no clinical hint of the underlying disease, except for unspecific abdominal discomfort in one case. In the literature the clinical finding is described as a rather soft abdominal tumourous mass. This disorder seems to follow a predominantly favourable course, even without therapy. Even today the etiology and pathogenesis of mesenterial lipodystrophy is unclear. Depending on the histological findings, very different terms have been applied to similar mesenterial processes.