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Related to lymphogenous: lymphogenous leukemia, lymphogenous metastasis
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In most such cases, the intracranial extension of tuberculosis is a result of hematogenous and lymphogenous spread rather than direct extension.
Stage IVb involves lymphogenous or hematogenous metastases.
Currently, this clinical manifestation is the strongest evidence that rickettsiae may initially spread by a lymphogenous route before hematogenous dissemination.