Abdominal and GI imaging: mesenteric lymphoma: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Abdominal and GI imaging: mesenteric lymphoma

Sample item

A patient with fever, night sweats and abdominal discomfort has CT showing bulky confluent mesenteric nodes that surround and elevate the mesenteric vessels without narrowing them. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Lymphoma

In lymphoma the nodes envelop the mesenteric fat and vessels, called the sandwich sign, but do not invade or narrow them. A carcinoid mesenteric mass shows calcification and a desmoplastic reaction that tethers and kinks the vessels. Retroperitoneal fibrosis is a plaque around the aorta, not mesenteric nodes.

Option by option

  • A. Sclerosing mesenteritis

    Sclerosing mesenteritis shows a fibrotic mass with a fat halo, usually in a well patient.

  • B. Carcinoid tumour

    A carcinoid mass is desmoplastic, often calcified and retracts or narrows the vessels.

  • C. Lymphoma (correct)

    Correct. Bulky nodes enveloping unnarrowed vessels is the lymphoma pattern.

  • D. Retroperitoneal fibrosis

    Retroperitoneal fibrosis forms a plaque around the aorta and ureters.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Lymphoma. In lymphoma the nodes envelop the mesenteric fat and vessels, called the sandwich sign, but do not invade or narrow them.

Why is "Sclerosing mesenteritis" not the answer?

Sclerosing mesenteritis shows a fibrotic mass with a fat halo, usually in a well patient.

Why is "Carcinoid tumour" not the answer?

A carcinoid mass is desmoplastic, often calcified and retracts or narrows the vessels.

Why is "Retroperitoneal fibrosis" not the answer?

Retroperitoneal fibrosis forms a plaque around the aorta and ureters.

What concept does this question test?

It tests Abdominal and GI imaging: mesenteric lymphoma in Radiology. A carcinoid mesenteric mass shows calcification and a desmoplastic reaction that tethers and kinks the vessels. Retroperitoneal fibrosis is a plaque around the aorta, not mesenteric nodes.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Abdominal and GI imaging: mesenteric lymphoma?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.