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BACKGROUND: Mesenteric alterations are associated with non-Hodgkin's lymphoma (NHL), but the frequency and prognostic value of mesenteric alterations are unknown in patients with NHL. PATIENTS AND METHODS: We retrospectively screened 120 patients that were treated for NHL between January 1996 and December 2001 for the presence of mesenteric alterations, defined on computed tomography (CT) scans as nodular or diffuse infiltration of the abdominal mesentery with increased density of mesenteric fat. RESULTS: 21 patients (17.5%) had radiological findings of mesenteric alterations at the time of the initial NHL diagnosis. Mesenteric alterations were significantly associated with mesenteric lymphadenopathy (p = 0.01). In about 50% of the patients, mesenteric alterations could not be explained by direct mesenteric tumour invasion or overt lymphatic obstruction. Patients with initial findings of mesenteric alterations tended to have a better 4-year survival as compared to patients without such findings (79 vs. 43%, p = 0.11). The International Prognostic Index (IPI) score was the only independent predictor of survival in the multivariate analysis. CONCLUSION: This retrospective screening study found a moderate prevalence of mesenteric alterations in patients with various subtypes of NHL. The diagnostic and prognostic value of mesenteric alterations should be further assessed in prospective studies.