Lymphoma is a type of blood cancer that develops in the lymphatic system. The lymphatic system is part of the immune system and helps fight infection and disease. Lymphoma occurs when lymphocytes, a type of white blood cell, grow and multiply uncontrollably. There are two main types of lymphoma – Hodgkin lymphoma and non-Hodgkin lymphoma. Lymphoma can develop in lymph nodes, the spleen, bone marrow, blood, or other organs. Suspecting lymphoma early is important for successful treatment. Here are some of the common signs and symptoms that may lead to a suspicion of lymphoma:
Swollen Lymph Nodes
One of the most common signs of lymphoma is swollen lymph nodes. Lymph nodes are small glands located throughout the body that make up part of the lymphatic system. Healthy lymph nodes are usually not visible or palpable. With lymphoma, the cancerous lymphocytes cluster in the lymph nodes causing them to swell. The swollen nodes are often painless. The location of swollen nodes can provide clues as to where the lymphoma started:
- Neck – Swollen lymph nodes in the neck are a common sign of Hodgkin lymphoma. Non-Hodgkin lymphoma may also cause swollen neck nodes.
- Armpits – Swollen nodes under the arms can indicate lymphoma in the chest area.
- Groin – Swollen nodes in the groin may suggest lymphoma in the abdomen or pelvis.
Lymph nodes can also swell due to infection. However, with an infection the nodes are usually painful and the swelling goes down with antibiotic treatment. Lymphoma nodes do not decrease in size with antibiotics. Any lymph nodes that remain swollen for more than 2-4 weeks without explanation warrant medical evaluation.
Unexplained Weight Loss
Unintentional weight loss is another red flag for lymphoma. Losing a significant amount of weight without trying can be due to the cancerous lymphocytes interfering with proper nutrition. Weight loss of more than 10% of body weight over a 6 month period should be evaluated for possible lymphoma.
Unexplained Fever
Fever over 101°F (38°C) that persists for several days can be a sign of lymphoma. The cancerous lymphocytes and swollen lymph nodes create inflammation that leads to elevated body temperature. Fevers related to lymphoma are typically not accompanied by other symptoms like sore throat or coughing. Fevers that cannot be explained by infection may point to an underlying blood cancer.
Drenching Night Sweats
Excessive sweating at night is another symptom that can indicate a lymphoma diagnosis. Patients may wake up soaked in sweat, even with minimal bedding. Night sweats can also be caused by infection or menopause. But new onset, drenching night sweats in someone without any of those explanations deserves medical investigation.
Itchy Skin
Itching without a rash, known as pruritus, can be associated with lymphoma. The itchiness is often localized to one area of the body. The underlying cause is unknown but may be related to cytokines released by lymphoma cells. Generalized itching all over should prompt evaluation by a doctor.
Feeling Full and Abdominal Pain
Lymphomas developing in the abdomen can grow large enough to make you feel full after eating only a small amount. Abdominal lymphomas can also cause pain or discomfort in the tummy area. The cancerous mass takes up space and presses on other organs, leading to sensations of bloating and fullness.
Chest Pain or Pressure
Hodgkin lymphoma often develops in lymph node chains in the chest, which can lead to chest pain. Non-Hodgkin lymphomas can also spread to chest lymph nodes or the thymus gland. The enlarged nodes may press on structures in the chest causing pain. Shortness of breath or coughing may also occur.
Itchy Rash
Cutaneous T-cell lymphoma is a rare type of non-Hodgkin lymphoma that develops in the skin. Early stage skin lymphomas often cause red, scaly, itchy rash. The rash may look like eczema at first. Rashes that do not clear with usual treatments may need a skin biopsy to test for cutaneous lymphoma.
Easy Bruising or Bleeding
Some types of non-Hodgkin lymphoma affect the bone marrow and cause low blood counts. A decrease in platelets can lead to excess bruising or bleeding. Nosebleeds, bleeding gums, or tiny reddish-purple dots under the skin called petechiae can occur. Unexplained bruising warrants lab testing.
Repeated Infections
Lymphoma can impair immunity and cause decreased levels of normal antibodies. This makes someone more prone to frequent infections like sinusitis, bronchitis, or urinary tract infections. Recurring infections of any kind in an adult may indicate an undiagnosed medical problem involving the immune system.
Fatigue
Excessive fatigue is a very common symptom of lymphoma. The cancerous cells crowd out normal white blood cells, leading to impaired immunity. This causes increased susceptibility to tiring infections. Fatigue is also just a natural symptom of the body trying to fight the cancer. Unexplained, chronic fatigue should always be checked out.
Liver or Spleen Enlargement
Some types of lymphoma can cause the liver or spleen to increase in size. These organs contain lymphoid tissue and are common sites for non-Hodgkin lymphoma to spread. An abnormally enlarged liver or spleen may be discovered on physical exam or imaging tests.
| Symptom | Possible Sign of Lymphoma |
|---|---|
| Swollen lymph nodes in neck, armpits or groin | Cancerous lymphocyte buildup in nodes |
| Unexplained weight loss | Cancer interfering with nutrition |
| Unexplained fever | Inflammation from cancer cells |
| Drenching night sweats | Unknown cause |
| Itchy skin | Possibly cytokines secreted by lymphoma cells |
| Abdominal fullness and pain | Enlarged lymph nodes pressing on organs |
| Chest pain or pressure | Enlarged chest lymph nodes |
| Itchy rash | Cutaneous T-cell lymphoma in the skin |
| Easy bruising or bleeding | Low platelets from bone marrow involvement |
| Repeated infections | Impaired immunity from lymphoma |
| Fatigue | General symptom of cancer |
| Enlarged liver or spleen | Lymphoma spread to these organs |
When to See a Doctor
Many of lymphoma’s symptoms are vague and mimic more common, benign conditions. However, it is important to make an appointment with your doctor to evaluate any of the following:
- Swollen lymph nodes lasting more than 2 weeks
- Unintentional weight loss without clear cause
- Fevers higher than 101°F without infection
- Drenching night sweats that soak clothing
- Severe itching with no rash
- Abdominal swelling or feeling of fullness
- Chest pain or pressure
- Skin rashes not clearing with usual treatments
- Easy bruising or excessive bleeding
- Fatigue, weakness or shortness of breath
Reporting your symptoms to a doctor right away gives the best chance for an early lymphoma diagnosis and successful treatment. Do not write off bothersome symptoms assuming they will just go away. Let your physician evaluate whether further testing may be needed to uncover a serious condition like lymphoma.
Diagnosing Lymphoma
If lymphoma is suspected based on symptoms and exam, doctors will run tests to confirm the diagnosis:
Blood Tests
Blood tests are usually done first to look for clues pointing to a lymphoma diagnosis. A complete blood count checks for low red blood cell, white blood cell, and platelet levels, which can indicate bone marrow invasion. The blood is also checked for abnormal lymphocytes and tumor markers associated with lymphoma.
Biopsy
A lymph node biopsy is needed to definitively diagnose lymphoma. This involves surgically removing all or part of an affected node and examining the cells under a microscope. A pathologist looks for the enlarged lymphocytes characteristic of lymphoma. Immunophenotyping and genetic tests help classify the lymphoma into more specific subtypes.
Bone Marrow Biopsy
Lymphoma often spreads to the bone marrow. A bone marrow biopsy and aspiration are procedures that extract bone marrow samples for examination. They determine if lymphoma has infiltrated the marrow.
Imaging Tests
Imaging studies like CT scans, PET scans, and MRIs are used to stage the lymphoma. This means determining the locations lymphoma has spread to. Imaging reveals enlargement in lymph nodes, spleen, liver and other areas which guides appropriate treatment.
Lumbar Puncture
A lumbar puncture or spinal tap checks if lymphoma has reached the cerebrospinal fluid. It involves inserting a needle between vertebrae in the lower back to collect a sample of CSF fluid for testing. A lumbar puncture is not needed in all patients.
Accurate diagnosis requires collaborating information from medical history, physical examination, blood tests, biopsies and imaging. A lymphoma diagnosis should be made by an oncologist or cancer specialist. Treatment varies widely based on the specific lymphoma subtype.
Outlook for Lymphoma Patients
The prognosis for lymphoma has improved dramatically in recent decades thanks to advances in cancer treatments. Survival rates vary significantly based on individual factors:
- Age – Younger patients have higher cure rates overall.
- Stage – Lymphoma caught early at stage I or II has better prognosis.
- Subtype – Some lymphoma subtypes are more treatable than others.
- Response to treatment – Patients who achieve remission generally do better.
- Overall health – Those with fewer comorbidities tend to have higher survival rates.
According to American Cancer Society statistics:
- The 5-year survival rate for Hodgkin lymphoma is 85%.
- The 5-year survival for non-Hodgkin lymphoma is 71%.
- Survival rates are poorer for lymphoma arising in the brain or spinal cord areas.
- Stage I Hodgkin lymphoma has a 5-year survival rate exceeding 90%.
Thanks to better recognition of symptoms and earlier diagnosis, the prognosis for lymphoma patients continues to improve. Lifelong monitoring is needed even after treatment to watch for potential recurrence. Through a combination of watchful awareness and medical advancements, lymphoma is becoming an increasingly curable diagnosis.
Conclusion
Suspecting possible lymphoma in its early stages is critical for prompt treatment and improved outcomes. Be aware of common lymphoma symptoms like swollen nodes, unexplained fevers, drenching sweats, unintentional weight loss, fatigue and itchy rash. See your doctor promptly if these symptoms arise and persist. With a high index of suspicion, regular medical care, and open communication, lymphoma can often be caught early when it is most treatable. Increased awareness and medical progress provide encouragement that lymphoma patients can look forward to continuing improvement in prognosis.