Presentation
Work up for abdominal pain and progressive distension.
Patient Data
Multiple varying size mesenteric, para aortocaval and parailiac enlarged lymph nodes are seen that surround but do not occlude vascular structures and also displace bowel loops and bilateral ureters, resembling sandwich or hamburger sign.
Several non-enhanced simple cortical cysts are seen in both kidneys.
The prostate gland is enlarged.
Case Discussion
A sandwich or hamburger sign, refers to confluent lymphadenopathy on both sides of the mesenteric vessels giving rise to an appearance described as the sandwich sign which is specific for mesenteric lymphoma (typically non-Hodgkin).