Non-Hodgkin’s Lymphoma: Recognizing the Symptoms

Health Writer
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Non-Hodgkin’s lymphoma (NHL) is a cancer that starts in the white blood cells called lymphocytes, which are part of the body’s immune system. This cancer most often affects adults, though it can occur in childhood. NHL usually starts in the lymph nodes or other lymph tissue, and can spread to the skin and other organs, including the bone marrow, thymus, adenoids, tonsils, spleen, and digestive tract.


Swollen lymph nodes

The enlarged lymph nodes associated with non-Hodgkin’s lymphoma are usually painless lumps in the sides of the neck, above the collar bone, in the groin area, or under the arms. In contrast, swollen lymph nodes caused by infections, which are more common, feel sore or tender.


Other common NHL symptoms

Additional symptoms can include chills, weight loss, fatigue, a swollen abdomen, feeling full after a small meal, chest pain or pressure, shortness of breath or cough, severe or frequent infections, and easy bleeding or bruising. Keep in mind, many of these can be signs of other conditions, too.


Abdominal signs of NHL

When lymphoma grows in the abdomen it can cause swelling and pain in the belly. This can be caused by enlarged lymph nodes, an enlarged spleen or liver, or a buildup of fluid. The spleen can push on the stomach and cause loss of appetite, or a feeling of fullness after eating even small meals. Lymphomas in the stomach or intestines can cause pain, nausea, or vomiting.


NHL in the chest

If lymphoma grows in the thymus or lymph nodes, it can press on the windpipe inside the chest, causing coughing, trouble breathing, chest pressure, or pain. If it presses on the superior vena cava (SVC), a large vein responsible for carrying blood from the head and arms to the heart, blood can back up in the veins. This can cause trouble breathing, swelling, and a bluish tinge in the head, arms, and upper chest. SVC syndrome can be life-threatening.


NHL in the brain and spinal cord

Central nervous system lymphomas, which are rare, can cause nausea and vomiting, headaches, mental confusion, weakness in the legs, arms, or face, and even seizures. If a lymphoma spreads to the area around the brain or the spinal cord, it can cause double vision, facial weakness, hearing loss, trouble speaking, difficulty walking, or paralysis on one side of the body.


NHL in the skin

Lymphoma which originates in the skin, rather than spreading from the lymph nodes, is a rare condition known as cutaneous lymphoma, which can be easily misdiagnosed as one of several other conditions. It may cause itchy red or purple bumps under the skin, often in areas of the body not normally exposed to sunlight. It may appear as a rash covering part of or most of the body (erythroderma).


Symptoms can vary based on speed of spread

Though not a hard and fast rule, indolent or slow-growing lymphomas may take time to cause any symptoms. Aggressive lymphomas may grow faster and quickly cause symptoms. Regardless of how quickly the lymphoma grows, it can spread to other parts of the lymph system or to certain areas of the body like the liver, brain, or bone marrow.


B symptoms: systemic, and more serious

There is also a group of secondary or “B symptoms” for NHL, which include a fever that can come and go for days or weeks that is not caused by an infection; drenching night sweats; and sudden, significant weight loss (10 percent or more of your body weight over six months). B symptoms may indicate a more aggressive lymphoma; if you experience them, you should see a doctor immediately.


It may not be lymphoma

Many of the symptom described in the previous slides can also be associated with other less serious health conditions or with other cancers. It’s important to check with your doctor when you experience any unexplained symptoms that persist, especially if there is a history of lymphoma in your family or you have risk factors for the disease. Early diagnosis is critical.