After reading your post I found this information which may be helpful to you. BTW, I am not a doctor but have Stage 4 PC, so I am always trying to find the latest information,
1. Metastasis pattern
Prostate cancer usually spreads to bone first, but it can spread to lymph nodes, liver, lungs, and adrenal glands without major bone disease — especially if it’s a more aggressive variant.
Lymphoma more commonly involves mediastinum, peritoneum, and multiple lymph node chains. So his pattern could look like lymphoma, but it isn’t proof.
2. Hormone resistance from the beginning
A small fraction of prostate cancers are resistant to hormone therapy right from the start.
Aggressive variants (like small-cell or neuroendocrine prostate cancer) behave this way too, and they often spread outside bone.
3. PSA and lymphoma
PSA is highly specific to prostate tissue.
Lymphoma itself does not produce PSA.
However, men with both prostate cancer and lymphoma at the same time could theoretically have an elevated PSA because of the prostate cancer.
But an elevated PSA should not be explained by lymphoma alone.
4. What usually happens in cases like this
Doctors sometimes do a repeat biopsy of a metastatic site if the spread pattern is unusual (like no bone disease but lots of visceral/lymph spread). This help confirm whether it’s all prostate cancer, or if there’s another cancer present (like lymphoma).
Imaging (PET/CT with a tracer like PSMA or FDG) can also help distinguish between the two.
In summary:
It is very rare for lymphoma by itself to cause a high PSA — that usually comes only from the prostate. The pattern of spread you have is less typical for prostate cancer, but it can happen, especially with aggressive types. Sometimes doctors will biopsy a lymph node or adrenal lesion just to be certain, so it might be worth asking your care giver your concern