Metastatic Pattern of Spread of Non-Hodgkin's Lymphoma
Introduction:
Non-Hodgkin's Lymphoma (NHL) is a wide spectrum of cancers and is treated here only superficially and in aggregate. Obviously the most common site of NHL is the lymph node. However, extra-nodal disease is common (approximately 30%) and can either represent the primary site or a metastasis.
Prevalence: Very Rare Metastasis Frequency: Common
References:
Radiology. 1991 Feb;178(2):315-21. PMID: 1987584
Ann Oncol. 2003 Jan;14(1):131-9. PMID: 12488305
Primary Tumor:
| Characteristics | Comments | |
| Distant Lymph Nodes | Enhancing | rare to calcify or be necrotic without treatment |
Known Metastatic Locations:
| Site | Frequency | Characteristics | Comments |
| Bone Marrow | Common | ||
| Spleen | Uncommon | Enlargement, Hypoenhancing | can be radiographically occult, manifest as enlargement of the spleen, or manifest as focal lesions |
| Stomach | Rare | ||
| Liver | Rare | Hypoenhancing | |
| Small Intestine | Rare | Local Wall Thickening, Dilation | typically not obstructed |
| Lung Parenchyma | Rare | Nodule, Consolidation | |
| Colon | Very Rare | Local Wall Thickening, Dilation | typically not obstructed; colonic involvement is relatively common in Burkitt's lymphoma |
| Pleura | Very Rare | ||
| Skin (Cutaneous and Subcutaneous) | Very Rare | cutaneous T cell lymphoma is also known as mycosis fungoides; if it involves internal organs, it is designated Sezary syndrome |
|
| Brain | Very Rare | Mass | primary CNS lymphoma typically manifests as a focal mass |
| Dura (Meninges) | Very Rare | secondary (metastatic) involvement of the CNS by lymphoma typically manifests by dural involvement, not an intraparenchymal mass |
|
| Breast | Very Rare | one of the most common sites of origin for extra-mammary metastatic disease to the breast | |
| Bone | Very Rare | Lytic, Mixed Lytic and Blastic | |
| Testes | Very Rare | Mass, Enlargement | can manifest as focal mass or diffuse infiltration |