Relationship between mesenteric abnormalities on computed tomography and malignancy

Clinical findings and outcomes of 359 patients

Zachary L. Smith, Humberto Sifuentes, Parakkal Deepak, David B. Ecanow, Eli D. Ehrenpreis

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

BACKGROUND:: Mesenteric abnormalities are detected on abdominal computed tomography (CT) performed for various indications. GOALS:: Determine the risk of malignancy on follow-up of patients with these abnormalities without a preexisting malignancy. STUDY:: Data were collected on all patients at NorthShore University HealthSystem with abdominal CT scan reports of mesenteric abnormalities labeled as "panniculitis" from January 2005 to April 2010. RESULTS:: Three hundred fifty-nine patients were identified, 81 (22.6%) had a known malignancy at the time of the index abdominal CT scan. Nineteen (6.8%) of the 278 had a new diagnosis of malignancy on evaluation of the findings of the index CT scan. Among the 240 (86.33%) that did not have a notation of the abnormality in their medical record, 11 (4.58%) developed a malignancy during the study period. Sixty-eight of the 248 (24.46%) without a known malignancy had diseases associated with mesenteric abnormalities. The presence of these were associated with a reduction in the likelihood that the abnormalities are associated with new or delayed diagnosis of a malignancy (odds ratio, 0.197; 95% confidence interval, 0.0045-0.8501; P=0.013). Progression of underlying malignancy was unlikely in those where the mesenteric abnormalities did not worsen in appearance on follow-up CT scans (odds ratio, 0.03268; 95% confidence interval, 0.0028-0.3761; P=0.0061). CONCLUSIONS:: In the presence of an underlying disease associated with these findings, the subsequent finding of a malignancy is less likely. In addition, neglect of these findings may result in delayed diagnosis of cancer.

Original languageEnglish (US)
Pages (from-to)409-414
Number of pages6
JournalJournal of Clinical Gastroenterology
Volume47
Issue number5
DOIs
StatePublished - May 1 2013

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Tomography
Neoplasms
Delayed Diagnosis
Odds Ratio
Confidence Intervals
Panniculitis
Medical Records

Keywords

  • computed tomography
  • panniculitis
  • peritoneal/complications
  • peritoneal/epidemiology
  • peritoneal/radiography
  • x-ray

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Relationship between mesenteric abnormalities on computed tomography and malignancy : Clinical findings and outcomes of 359 patients. / Smith, Zachary L.; Sifuentes, Humberto; Deepak, Parakkal; Ecanow, David B.; Ehrenpreis, Eli D.

In: Journal of Clinical Gastroenterology, Vol. 47, No. 5, 01.05.2013, p. 409-414.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND:: Mesenteric abnormalities are detected on abdominal computed tomography (CT) performed for various indications. GOALS:: Determine the risk of malignancy on follow-up of patients with these abnormalities without a preexisting malignancy. STUDY:: Data were collected on all patients at NorthShore University HealthSystem with abdominal CT scan reports of mesenteric abnormalities labeled as {"}panniculitis{"} from January 2005 to April 2010. RESULTS:: Three hundred fifty-nine patients were identified, 81 (22.6{\%}) had a known malignancy at the time of the index abdominal CT scan. Nineteen (6.8{\%}) of the 278 had a new diagnosis of malignancy on evaluation of the findings of the index CT scan. Among the 240 (86.33{\%}) that did not have a notation of the abnormality in their medical record, 11 (4.58{\%}) developed a malignancy during the study period. Sixty-eight of the 248 (24.46{\%}) without a known malignancy had diseases associated with mesenteric abnormalities. The presence of these were associated with a reduction in the likelihood that the abnormalities are associated with new or delayed diagnosis of a malignancy (odds ratio, 0.197; 95{\%} confidence interval, 0.0045-0.8501; P=0.013). Progression of underlying malignancy was unlikely in those where the mesenteric abnormalities did not worsen in appearance on follow-up CT scans (odds ratio, 0.03268; 95{\%} confidence interval, 0.0028-0.3761; P=0.0061). CONCLUSIONS:: In the presence of an underlying disease associated with these findings, the subsequent finding of a malignancy is less likely. In addition, neglect of these findings may result in delayed diagnosis of cancer.",
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N2 - BACKGROUND:: Mesenteric abnormalities are detected on abdominal computed tomography (CT) performed for various indications. GOALS:: Determine the risk of malignancy on follow-up of patients with these abnormalities without a preexisting malignancy. STUDY:: Data were collected on all patients at NorthShore University HealthSystem with abdominal CT scan reports of mesenteric abnormalities labeled as "panniculitis" from January 2005 to April 2010. RESULTS:: Three hundred fifty-nine patients were identified, 81 (22.6%) had a known malignancy at the time of the index abdominal CT scan. Nineteen (6.8%) of the 278 had a new diagnosis of malignancy on evaluation of the findings of the index CT scan. Among the 240 (86.33%) that did not have a notation of the abnormality in their medical record, 11 (4.58%) developed a malignancy during the study period. Sixty-eight of the 248 (24.46%) without a known malignancy had diseases associated with mesenteric abnormalities. The presence of these were associated with a reduction in the likelihood that the abnormalities are associated with new or delayed diagnosis of a malignancy (odds ratio, 0.197; 95% confidence interval, 0.0045-0.8501; P=0.013). Progression of underlying malignancy was unlikely in those where the mesenteric abnormalities did not worsen in appearance on follow-up CT scans (odds ratio, 0.03268; 95% confidence interval, 0.0028-0.3761; P=0.0061). CONCLUSIONS:: In the presence of an underlying disease associated with these findings, the subsequent finding of a malignancy is less likely. In addition, neglect of these findings may result in delayed diagnosis of cancer.

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