Multiple extranodal sites at presentation in non-Hodgkin's lymphoma

About one-third of NHL patients present lymphomas at extranodal sites. Involvement of multiple noncontiguous extranodal sites at presentation without lymph node involvement is unknown. Herein we present two such cases. The first patient had sinonasal tract and urinary bladder NHL at presentation, while the other patient presented with bilateral adrenal involvement in addition to sinonasal tract NHL. Clinical presentation and pathophysiology are discussed, and a brief review of literature is included.