The imaging findings are in keeping with stage 4 high-grade lymphoma with extensive supra and subdiaphragmatic nodal disease, splenic involvement and bilateral lung, and osseous disease.
The multiple bilateral solid pulmonary nodules have the main differentials made between lymphoma deposits or infection (e.g. invasive Aspergillus). Given the fact that the nodules were circumscribed and were not surrounded by a halo of ground-glass attenuation, lymphoma was favored 1. Further imaging follow-up after chemotherapy (not shown) has demonstrated shrinkage of all infra and supradiaphragmatic lesions evenly.