Mode of Spread in Patients With Localized Malignant Lymphoma

VARIOUS concepts as to whether or not any of the types of lymphoma are ever truly localized continue to influence concepts of therapy. High dosage radiotherapy with or without the use of "prophylactic irradiation" to clinically benign areas in the management of apparently localized Hodgkin's disease has been advocated by those who feel that this disease is often localized and potentially curable.¹⁻³ Reports have indicated that in a significant portion of patients with Hodgkin's disease an initially localized disease process spreads by direct extension to the adjacent lymph node region only.³⁻⁷Some forms of lymphosarcoma restricted to the spleen⁸and reticulum cell sarcoma confined to the gastrointestinal tract⁹or bone¹⁰have been reported as curable. In the more usual forms of lymphosarcoma and reticulum cell sarcoma extension is not usually limited to adjacent areas, secondary involvement, even in cases apparently initially localized, being to distant