lymphomas frequently present as systemic diseases rather than localized sometimes localize it very often systemic this man came in this is an old old photograph and you see general swelling in his neck here you can see here's his classical he's got a super cobra killer mode there similar supercritical in though there he noticed those but his armpits were full of enlarged lymph nodes by chest x_-ray has me this time was widened and full of lymph nodes his abdomen was full of enlargement bones he presented with a systemic disease this was a a widely disseminated lymphoma 