Imaging

For lymphomas, imaging is critical to determine primary site. Using the Primary Site Coding Instructions, registrars need to determine all the areas of involvement from imaging, and then from the rules, determine the appropriate primary site.

  • Note: Any mention of the terms including fixed, matted, mass in the hilum, mediastinum, retroperitoneum, and/or mesentery, palpable, enlarged, shotty, lymphadenopathy/adenopathy are all regarded as involvement for lymphoma.

In advanced cases, it is not possible to determine with 100% accuracy where the lymphoma originated. The Primary site coding instructions were written so that registrars would apply the same set of rules to provide consistency in reporting.

Imaging is also critical for staging of lymphomas since surgery is rarely done.

Modality Utility
CT Scan, Positron Emission Tomography (PET)/CT Primary site
Staging for lymphomas
Monitoring disease progression>
Looking for other possible areas of metastatic disease (bone, brain, liver, spleen)
Bone scan Bone scans may be done if there is suspected bone involvement (this is different than bone marrow involvement)

See Diagnostic Tests | SEER Training website for more information on imaging.

Document imaging details in NAACCR # 2530: Text-Dx Proc-X-ray scan

Document results of Scopes in NAACCR Item # 2540: Text-Dx Proc-Scopes

Updated: December 2, 2025