Metastatic patterns of cancers of the lymphopoietic system in man

Autopsy records are analyzed for 358 patients with reticulum cell sarcoma, lymphocytic lymphosarcoma, or Hodgkin's disease. These records belong to a series of 4,728 autopsy records collected by the Department of Pathology at Roswell Park Memorial Institute from 1957 through 1965. This paper analyzes the distribution of metastases at specific sites in 3 malignant lymphomas. The concept of soil specificity is discussed in connection with the excess of metastases at specific sites. Soil specificity is defined as a higher than expected occurrence of metastases due to a cancer in an organ when compared to other similar primary cancers. In some instances, however, the excess of metastases in a specific site was sometimes also related to the site of origin of a malignant lymphoma. Entire series of organs located either in the abdomen or pelvis showed metastatic patterns which were very likely related to the primary sites of origin. The metastatic patterns of lymphocytic lymphosarcoma and reticulum cell sarcoma appeared to be markedly different from those of Hodgkin's disease. Reticulum cell and lymphocytic lymphosarcomas were not only more widespread than Hodgkin's disease, but the patterns of abdominal and pelvic metastases strongly suggested either their multifocal origin or a different sequence of events in the seeding of lymph node areas, as compared to those of Hodgkin's disease. The relationship between the degree of anaplasia of certain lymphomas and blood-borne metastases is discussed.