Lymphoma Symptoms and Signs

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Non-Hogkin’s Lymphoma may present with any one or more of the following symptoms. Sometimes there may be no symptoms, and sometimes other disease conditions may cause similar symptoms. Therefore, further investigations may be required to confirm the diagnosis.

What are the Signs and Symptoms of Lymphoma?

lymphoma-symptoms

  • Painless swelling of lymph nodes especially those in the neck, under the arm, or in the groin. Often these lymph nodes appear as a lump under the skin which gets bigger over time. Note that some other cancers and infections may also cause swollen lymph nodes.
  • Enlarged spleen and/or liver.
  • B Symptoms: Unexplained weight loss, Fever (>38 degree Celsius), and night sweats occur in many patients with NHL.
  • Fatigue and weakness attributable to anemia, other anemia-related symptoms may include shortness of breath and dizziness.
  • Loss of appetite.
  • Cough or chest pain mainly due to swollen lymph nodes in the chest pressing on the trachea.
  • Swelling in abdomen.
  • Headache, weakness, confusion, mood changes, and seizures may appear when lymphoma affects the brain.
  • Itching and other skin involvement signs may be visible in some NHL types mainly involving skin.

Besides above listed common symptoms, other symptoms may appear depending upon the type of NHL and site of disease.

Any one or more of the above symptoms if present may require further investigations to confirm the diagnosis and for staging and treatment.

What are B symptoms in Lymphoma?

B symptoms are important for prognostic purpose and help in staging of lymphoma. In the absence of any B symptoms, suffix A is added. If one or more symptom is present, suffix B is added in front of stage.

The B symptoms are as follows-

  1. Unexplained weight loss of more than 10% in the past 6 months
  2. Drenching night sweats
  3. Unexplained fever >38°C 

Where does Lymphoma usually start and How does it progress? 

Lymphoma is an uncontrolled proliferation of lymphocytes in the lymphoid organs. It may involve extralymphoid organ also (suffix E should be added with stage in such cases). It usually starts from one or more lymph node region or extranodal site.

Nodal Region

In Hodgkin’s Lymphoma, it usually start from one site and progresses in a contiguous fashion to involve nearby lymph node sites in a predictable manner. Whereas, in a Non-Hodgkin’s lymphoma (NHL) it may progress in a non-contiguous manner to involve distant sites. But the pattern of involvement may differ in low-grade and high-grade NHLs. 

Extranodal Region

In some cases (mostly NHLs and T Cell lymphoma) lymphoma may arise from extranodal sites (primary extranodal lymphoma) like skin, CNS, gastrointestinal tract, eye, thyroid gland etc.

  • Orbit – Follicular Lymphoma, MALT lymphoma
  • Scalp – Follicular Lymphoma
  • Submandibular Gland – Follicular Lymphoma, MALT lymphoma
  • Maxilla – Extranodal NK/T Cell Lymphoma, Plasmablastic Lymphoma, DLBCL
  • Nasal Cavity – Extranodal NK/T Cell Lymphoma, Follicular Lymphoma
  • Parotid Gland – DLBCL
  • Mandible – DLBCL
  • Thyroid – DLBCL
  • Lacrimal Gland – DLBCL

What are the first signs of Lymphoma?

The first signs and symptoms of lymphoma may be due to the local or systemic manifestations.

Local Symptoms/Signs

  • Nodal swellings in neck, axilla and/or groin
  • Abdominal distension or discomfort
  • Back pain
  • Cough, breathlessness, chest discomfort
  • Enlargement of liver and/or spleen
  • Headache, altered sensorium
  • Symptoms due to extranodal site involvement

Systemic or Constitutional Symptoms/Signs

  • Unexplained weight loss
  • Drenching night sweats
  • Unexplained fever >38°C 

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