Sandwich sign

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Abdominal pain and palpable mass on physical exam.

Patient Data

Age: 75 years
Gender: Male
ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial C+ portal
venous phase
This study is a stack
Axial C+
delayed
This study is a stack
Coronal C+ portal
venous phase
This study is a stack
Sagittal C+ portal
venous phase
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Info

Innumerable mesenteric, retrocrural, retroperitoneal and pelvic lymphadenopathies surrounded but do not occlude the mesenteric vessels and displace bowel loops but do not occlude them. Features are compatible with sandwich sign also known as a hamburger sign.

The prostate gland is enlarged and its central portion protrudes cephalad into urinary bladder base.
Degenerative changes as osteophytosis are seen at the lumbar spine.

Case Discussion

Sandwich sign refers to confluent lymphadenopathy on both sides of the mesenteric vessels which is specific for mesenteric lymphoma (typically non-Hodgkin).

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