Lymphoma is a type of cancer that affects the lymphatic system, which is part of the body’s immune system. Lymphoma causes tumors, called lymphomas, to grow in lymph nodes or other tissues of the lymphatic system. One of the most common early signs of lymphoma is painless swelling of lymph nodes, called lymphadenopathy. This article provides an overview of how big lymphoma lump sizes typically are.
What causes lymphoma lumps?
Lymphoma occurs when lymphocytes, a type of white blood cell, undergo changes (mutations) that cause them to grow and multiply uncontrollably. This uncontrolled growth causes lumps or tumors to form in the lymph nodes or other lymphatic tissues. There are two main types of lymphoma:
- Hodgkin lymphoma – Named after Dr. Thomas Hodgkin, who first described it in 1832. This type of lymphoma spreads in an orderly manner from one group of lymph nodes to the next.
- Non-Hodgkin lymphoma – A diverse group of blood cancers that include any lymphoma except Hodgkin lymphoma. The lump pattern is more erratic than Hodgkin lymphoma.
Both types of lymphoma cause similar symptoms, with enlarged, painless lumps in the lymph nodes as a hallmark sign. The enlarged lymph nodes are referred to as lymphoma lumps or lymphadenopathy.
Typical size of lymphoma lumps
The size of lymphoma lumps can vary greatly, ranging from very small lumps just under the skin to quite large lump masses in the abdomen. Some general guidelines on lymphoma lump sizes include:
- Early stage lymphoma lumps are often small, around 1-2 cm (half to one inch) in size.
- As lymphoma progresses, lumps tend to increase in size and additional lumps may form.
- Larger lumps over 2 cm (one inch) are more concerning for lymphoma.
- Very large lumps over 5-10+ cm (2 to 4+ inches) often indicate advanced stage lymphoma.
However, lymphoma lump size is not the only factor in determining lymphoma stage and severity. The location, number of lumps, and other symptoms are also important.
Typical locations
Some of the most common locations for lymphoma lumps include:
- Neck – Lymph nodes in the neck, under the jaw and chin or on the side of the neck. Cervical lymphadenopathy.
- Armpits – Swollen lymph nodes under the arms. Axillary lymphadenopathy.
- Groin – Enlarged lymph nodes in the groin area. Inguinal lymphadenopathy.
- Abdomen – Lymph nodes in the abdomen and pelvis can swell internally and form a lump or mass that can be felt through the abdominal wall.
- Chest – Swollen mediastinal or hilar lymph nodes in the chest may be seen on imaging tests.
What does the lump feel like?
In addition to the size and location of lymphoma lumps, the texture and feel of the lump can also provide clues:
- Lymphoma lumps are generally smooth, firm and rubbery to the touch.
- They are typically painless, non-tender, and feel solid all the way through.
- The lump often feels rounded, oval or bean-shaped rather than irregular.
- The lump is not able to be moved around easily under the skin and feels fixed in place.
Other related signs and symptoms
While lump size is important, looking at the full clinical picture is key for evaluating lymphoma. Other signs and symptoms that often occur along with enlarged lymph nodes include:
- Fatigue
- Unexplained weight loss
- Fever and chills
- Night sweats
- Itching skin
- Cough or trouble breathing (with mediastinal lymphoma)
- Feeling full and inability to eat much (with abdominal lymphoma)
Evaluating lump size and risk factors
If you discover any enlarged lymph nodes, especially along with other symptoms, it’s important to see your doctor as soon as possible. The doctor will examine all areas for lumps, carefully noting the size, texture, and location of any swollen nodes. Some key points in lump evaluation include:
- Lump size – Larger lumps or lumps that are continuing to grow raise suspicion for lymphoma.
- Age – Lymphoma risk increases with age. Most cases occur in those over age 60.
- Location – Certain lump locations, like the chest or abdomen, have higher lymphoma risk.
- Firm, rubbery feel – A hard lymph node that feels fixed in place raises lymphoma concern.
- Additional symptoms – Systemic symptoms in combination with lumps increase risk.
- Persistence – Lymph nodes that remain enlarged for several weeks warrant medical evaluation.
Medical evaluation of lymphoma lumps
If lymphoma is suspected based on the clinical lymph node evaluation, the doctor will order imaging tests to better visualize the internal lump size, location, and distribution. Common lymphoma lump imaging tests include:
- CT scan – Provides 3D cross-sectional images of lumps throughout the body, including the abdomen and pelvis.
- PET scan – Uses a radioactive tracer to light up areas where lymphoma is metabolically active.
- Ultrasound – Uses sound waves to create images of lumps and identify any fluid-filled areas.
- MRI – Provides enhanced imaging of soft tissue lymphoma lumps and lymph nodes.
- Chest X-ray – Can detect swollen lymph nodes in the chest.
A lymph node biopsy is usually also performed to remove all or part of an affected node for pathological testing. Examining the cells under a microscope can definitively diagnose lymphoma and determine the specific subtype.
Staging based on lymphoma lump sizes and locations
Once a lymphoma diagnosis is confirmed, imaging and biopsy results enable doctors to assign a stage based on where lumps are located and their size:
| Stage | Description |
|---|---|
| Stage I | Single lymph node region or single organ involvement |
| Stage II | Two or more lymph node regions on the same side of the diaphragm |
| Stage III | Lymph node regions or organs on both sides of the diaphragm |
| Stage IV | Widespread disease including multiple organs with or without lymph node involvement |
Higher stages indicate more advanced disease based on the extent of lymphoma spread. In general, the larger the bumps or masses and the more areas affected, the higher the stage.
Treatment considerations with lump size
Lymphoma lump size and location factor into treatment options and prognosis. Some key points include:
- Smaller lumps may be treated with radiation alone, while larger lumps often require chemotherapy.
- Bulky disease over 10 cm requires more aggressive chemotherapy regimens.
- Advanced stage lymphoma with widespread large masses has a poorer prognosis.
- Removal of large lumps via surgery is rarely done, as lymphoma usually involves multiple nodes.
However, treatment response and outcomes depend on many aspects beyond just lump size. The lymphoma subtype and patient factors like age and overall health are also important considerations.
Monitoring lump changes during and after treatment
Lymphoma lump size is carefully monitored throughout treatment to gauge response:
- Imaging tests are repeated to evaluate whether lumps are shrinking in response to chemotherapy or radiation.
- Lumps that continue to grow despite treatment may signify resistant or progressive disease.
- Significant decrease in lump size is a positive sign suggesting the lymphoma is responding favorably.
After treatment is completed, periodic monitoring helps check for potential recurrence:
- Any new lumps or growth of previously existing lumps after treatment need quick evaluation.
- Enlarging lumps may indicate lymphoma recurrence and warrant repeat biopsy.
- Imaging tests may be done at follow-up visits to detect subtle lump changes.
Outlook for lymphoma by lump size
The outlook and prognosis for an individual person with lymphoma depends on many medical factors, including but not limited to the size of disease lumps. Some general statistics on 5-year survival rates by stage include:
| Stage | 5-Year Relative Survival Rate |
|---|---|
| Stage I | 80-90% |
| Stage II | 70-80% |
| Stage III | 60-70% |
| Stage IV | 50-60% |
With modern treatments, overall lymphoma survival rates have improved significantly. Early stage lumps that are small and limited often have a very favorable outlook when treated promptly. However, larger lumps and advanced stage disease remain challenging to treat.
Conclusion
Lymphoma lump size can vary widely but is an important factor in lymphoma staging, treatment, and prognosis. Lumps are often the presenting symptom that prompts further evaluation. Smaller lumps around 1-2 cm are typical at diagnosis, but larger lumps correlate with more advanced disease. The location of lumps also provides key information. A thorough clinical exam combined with imaging tests enables doctors to assess the full extent of lymphoma involvement throughout the body. Monitoring lump response helps guide ongoing treatment. While large and extensive lymphoma lumps are more concerning, modern treatments are improving outcomes and survival even for advanced stage disease.