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Hamburger sign

Case contributed by Laughlin Dawes
Diagnosis possible

Presentation

Abdominal pain, abdominal distention, acidosis and elevated lactate. Known case of chronic lymphocytic leukemia. CT was performed for possible ischemic colitis.

Patient Data

Age: 75 years
Gender: Female
ct

Cecal pneumatosis and dilatation consistent with ischemia.

Mesenteric and para-aortic nodal mass giving the hamburger sign appearance consistent with the known case of chronic lymphocytic leukemia.

Case Discussion

A sandwich sign, sometimes known as a hamburger sign, refers to a mesenteric nodal mass, either para-aortic or not, giving an appearance of a hamburger.

The sign is specific for mesenteric lymphoma (typically non-Hodgkin), unless the patient has had a transplant. If so, post-transplant lymphoproliferative disorder should be considered.

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