Presentation
Abdominal pain and mass feeling.
Patient Data
Multiple lymphadenopathies are seen at peri-aortic regions that encases celiac, superior mesenteric and both renal arteries causing sandwich sign. Several enlarged lymph nodes also are noted at peripancreatic and perigastric spaces. Some lesions are in close contact with lesser curvature of the stomach seems to invades it.
A 21×16mm low-enhancing mass also is noted at pancreatic head.
A 28mm stone is noted within the gallbladder.
The left kidney is small and atrophic. Moderate to severe hydronephrosis is seen at left kidney due to a 14mm proximal ureteral stone (1120HU). Several stones also are seen within the dilated pelvicalyceal system of the left kidney less than 10mm. A 28mm exophytic cortical cyst is noted at left kidney.
A few small simple cortical cysts are seen at right kidney.
A few stones are seen within the urinary bladder less than 13mm.
The prostate gland is enlarged.
Case Discussion
Para-aortic infiltrative mass; path proven lymphoma. Confluent lymphadenopathy on both sides of the mesenteric vessels gives rise to an appearance described as the sandwich sign.