Sandwich Sign
Hamburger Sign

General Considerations

• CT appearance of mesenteric fat and vessels "sandwiched" between two nodular layers of mesenteric lymphadenopathy
  • Also seen on ultrasound
• Highly suggestive of mesenteric lymphoma
  • Usually non-Hodgkin's variety (NHL)
• Mesenteric masses occur in 30-50% of patients with NHL
• Frequently associated with retroperitoneal adenopathy as well
• Sandwich sign may also be seen in patients with post-transplantation lymphoproliferative disorder

Sandwich Sign. Axial contrast-enhanced CT images of the abdomen and pelvis
demonstrate lobulated, lymphadenopathy (white arrows) "sandwiching" mesenteric vessels and fat (red arrows) in a pattern suggestive of mesenteric lymphoma. There is also retroperitoneal adenopathy (black arrows).
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The Sandwich Sign. Hardy, S.  Radiology,  226,  651-652.