The Sandwich Sign

Transverse computed tomographic (CT) image obtained with oral and intravenous contrast material in a patient with mesenteric non-Hodgkin lymphoma (NHL). Image shows two large mesenteric lymphoma masses, which represent the halves of the sandwich bun (arrows), enveloping mesenteric fat and enhanced vessels.
Note that the enhanced small bowel lies outside of the sandwich. Extensive retroperitoneal lymphadenopathy (arrowheads) is present, as well.


Transverse CT image obtained with oral and intravenous contrast material in a patient who underwent left pelvic renal allograft transplantation 6 months earlier and now has mesenteric posttransplantation lymphoproliferative disorder (PTLD).
Mesenteric lymphoma mass (solid arrow) just to the right of the pelvic kidney (arrowhead) has produced a sandwich sign. Retroperitoneal lymphadenopathy (open arrows) is also seen.