Reason: mesenteric mass seen on laparoscopy at OSH and ill defined on CT scan History: MassAdditional history per electronic medical record: 62Yrs male who underwent an elective laparoscopic umbilical hernia repair in February of this year. At that time they saw a mass within his left upper abdomen. It is described as just below the transverse colon and within the mesentery. It is variably described as possibly fluid filled and also possibly pulsatile. It was measured to be over 12cm. He then had a biopsy of the mass on 6/17/16 which showed fat necrosis and red/white blood cells. ABDOMEN:LIVER, BILIARY TRACT: No significant abnormality noted.SPLEEN: No significant abnormality noted.PANCREAS: No significant abnormality noted.ADRENAL GLANDS: No significant abnormality noted.KIDNEYS, URETERS: No significant abnormality noted.RETROPERITONEUM, LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is an approximately 14.3 x 7.8 cm area of fat stranding involving the macroscopic fat of the small bowel mesentery centered at the mesenteric root (series 6, image 36) with associated mild restricted diffusion, a pseudocapsule, and relatively uninvolved fat surrounding the vessels ("fat halo" sign). The process does not narrow the mesenteric vasculature, and there is no associated discrete lymphadenopathy or solid mesenteric masses.Mild colonic diverticulosis without evidence of diverticulitis.BONES, SOFT TISSUES: No significant abnormality noted.OTHER: No significant abnormality noted.
1.Signal abnormality involving an approximately 14 cm portion of the small bowel mesentery with imaging features most suggestive of mesenteric panniculitis given evidence of a pseudocapsule and "fat halo" sign, with sclerosing mesenteritis considered less likely due to lack of discrete soft tissue nodularity. Metastases or neoplasm are additional less likely differential considerations (also secondary to absence of nodular soft tissue signal), but are not entirely excluded.2.Findings suggestive of prostatic neoplasm involving the left peripheral zone mid gland. Correlation with PSA levels and urologic consultation are recommended.