What Is Mesenteric Lymphoma?

Mesenteric lymphoma is a cancer that develops in a layer of tissue inside your abdomen. It often causes a noticeable lump and stomach pain. Other symptoms include cramping, loss of appetite, and unintentional weight loss.

Mesenteric lymphoma is a cancer that develops in lymph nodes inside of your mesentery. The mesentery is a folded membrane that’s attached to your intestines and abdominal wall to keep them in place.

The most common type of mesenteric lymphoma is follicular lymphoma. Follicular lymphoma is the second most common type of non-Hodgkin’s lymphoma. It develops in a kind of white blood cells called B cells.

Mesenteric lymphoma is referred to as primary mesenteric lymphoma when it develops in your mesentery. It’s called secondary mesenteric lymphoma if it spreads to your mesentery from other parts of your body. Most cases of mesenteric lymphoma are secondary.

Read on to learn more about mesenteric lymphoma including what causes it, potential symptoms, and treatment options.

Lymphoma is a group of cancers that develop in your lymph system and are characterized by the uncontrolled replication of white blood cells. It’s broadly divided into two main categories: non-Hodgkin’s and Hodgkin’s lymphoma.

Mesenteric lymphoma is when lymphoma develops in the lymph nodes inside of your mesentery. Mesenteric tumors are very rare. A 2010 study estimates that they affect 1 out of 200,000 to 350,000 people. They make up about 1% to 3.6% of all gastrointestinal lymphomas.

The most common type of lymphoma to develop in your mesentery is called follicular lymphoma. Follicular lymphoma accounts for about 30% of all lymphomas.

A more aggressive type of lymphoma called diffuse large B-cell lymphoma can also develop in your mesentery.

Is mesenteric lymphoma curable?

Little is known about the outlook of mesenteric lymphoma due to its rarity. Cases of mesenteric lymphoma being successfully treated have been reported in the medical literature.

For example, in a 2019 study published in Clinical Lymphoma Myeloma and Leukemia, researchers reported successful treatment of diffuse large B-cell lymphoma affecting the mesentery with chemotherapy and radiation therapy.

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Mesenteric lymphoma often causes a noticeable abdominal mass and abdominal pain. Other symptoms can include:

• cramping
• loss of appetite
• nausea and vomiting
• unintentional weight loss

Dermatitis herpetiformis

A gluten insensitivity disease called dermatitis herpetiformis — which is an itchy, blistering rash — can increase your chance of developing lymphoma. The most common type of lymphoma associated with dermatitis herpetiformis is enteropathy-associated T-cell lymphoma.

Thrombocytopenia

In rare cases, people with mesenteric lymphoma may also develop thrombocytopenia. Thrombocytopenia is when your body produces a fewer than normal level of platelets and your blood doesn’t clot properly. Symptoms include easy bruising or unexpected or prolonged bleeding.

Mesenteric panniculitis

Mesenteric panniculitis is also strongly associated with cancer, especially lymphoma and colorectal cancer. Mesenteric panniculitis is an inflammatory disease of the fat tissue of your mesentery that can cause symptoms such as:

Bowel obstruction

In rare cases, mesenteric lymphoma can lead to bowel obstruction. Bowel obstruction is when a blockage prevents food and water from moving through your bowel.

In a 2022 case study, researchers presented a case of a woman in her 60s with mesenteric lymphoma. She reportedly experienced nausea, vomiting, and abdominal pain for several days. Examination revealed she had bowel obstruction caused by two mesenteric lymphoma tumors.

Researchers aren’t exactly sure why some people develop mesenteric lymphoma, but the most common type of mesenteric lymphoma is follicular lymphoma.

In most cases, it’s not known why follicular lymphoma develops. It’s more common in white Americans than Asian or African Americans, and about half of people are over the age of 55 when they’re diagnosed. It’s rare in people under 20.

Exposure to some pesticides and herbicides are known risk factors .

Your doctor will begin a diagnosis by asking you about your symptoms and reviewing your medical history. They may be able to feel a lump in your abdomen during a physical exam.

The next step of the diagnostic process involves imaging scans. Your doctor will likely order computed tomography (CT) scans to help identify enlarged lymph nodes as well as the size and location of your tumor.

A characteristic feature of mesenteric lymphoma on a CT scan is the “sandwich sign” or “hamburger sign” named after the shape of the mass.

To confirm that you have cancer, a surgical biopsy is usually needed. A biopsy can often be performed laparoscopically through a small incision.

After a surgical biopsy is performed, a pathologist will examine the retrieved specimen under a microscope to determine if it is cancerous or noncancerous. If it is cancerous, a pathologist can often determine the origin of the cancer.

Mesenteric lymphoma is primarily treated with surgery to remove the tumor followed by chemotherapy.

A mixture of chemotherapy drugs is often administered. In a 2019 study published in Clinical Lymphoma Myeloma and Leukemia, 23 people with diffuse large B-cell mesentery lymphoma were treated with R-CHOP or R-EPOCH chemotherapy followed by radiation therapy.

The R-Chop regimen contains:

• rituximab, an immunotherapy drug
• cyclophosphamide
• doxorubicin
• vincristine
• prednisone

And the R-EPOCH regimen contains:

• rituximab
• etoposide
• prednisone
• vincristine
• cyclophosphamide
• doxorubicin

Three of the 23 participants in the study also received a bone marrow transplant.