The hamburger sign (sandwich sign).

Abstract

Since its debut at the 1904 World’s Fair in St. Louis [1], the hamburger (Fig. 1A) has become a defining symbol of American fast food culture. The hamburger (or sandwich) sign was first described in 1976 as a sonographic finding specific for mesenteric lymphoma [2]; a similar appearance can be found on computed tomography (Fig. 1B) and magnetic resonance imaging as well [3–5]. Confluent mesenteric adenopathy surrounding the mesenteric vessels is reminiscent of a beef patty (mesenteric vasculature and fat) sandwiched in a bun (the adenopathy) (Fig. 1B) [6]. This finding typically indicates lymphoma, most commonly non-Hodgkin [4–6]. In the appropriate clinical setting, post-transplant lymphoproliferative disease would be an additional differential diagnostic consideration [5].