In non-Hodgkin's lymphoma, lymph node enlargement is typically:

• A. Enlarged lymph nodes that form an adjacent line of enlargement
• B. Painful widespread enlarged lymph nodes
• C. Noncontiguous enlarged lymph nodes
• D. Enlarged lymph nodes primarily in the neck and axillary region

Answer: (C)

Non-Hodgkin's lymphoma commonly shows involvement of multiple lymph node regions that are not next to each other, and it can extend to extranodal sites as well. This noncontiguous spread reflects the disease’s tendency to disseminate widely through lymphatic and hematogenous pathways, so you may palpate enlarged nodes in several non-adjacent areas rather than a single continuous chain. The nodes are typically painless, which fits with lymphoid malignancies rather than inflammatory or infectious causes that often cause tenderness. By contrast, Hodgkin lymphoma more often spreads contiguously from one nodal group to the next, which is why noncontiguous enlargement is the characteristic pattern described here. In other words, the hallmark is scattered, non-adjacent nodal involvement rather than a single, orderly spread in a localized region.