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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on July 21, 2021.

Non-Hodgkin lymphoma symptoms

The human body has more than 500 lymph nodes connected through a network of lymph vessels. The neck, armpits, groin, abdomen, pelvis and chest have clusters of lymph nodes. These bean-shaped glands produce immune cells and filter impurities from the lymphatic system and bloodstream. It is possible for non-Hodgkin lymphoma to develop anywhere in the body where lymph nodes exist. The disease also may affect organs, such as the liver, stomach and lungs.

Early warning signs of non-Hodgkin lymphoma

Because many types of non-Hodgkin lymphoma involve different organs, signs and symptoms may vary depending on the type, location and stage of the disease. Symptoms tend to be fairly non-specific and may share similar characteristics with other illnesses, such as a cold, the flu or a respiratory infection. About two-thirds of people with non-Hodgkin lymphoma experience swelling in their lymph nodes, according to an article in StatPearls. Some people may not experience any apparent symptoms until the cancer becomes advanced.

One of the most common signs of non-Hodgkin lymphoma is enlargement of one or more of the lymph nodes, which causes a non-painful lump under the skin. Most commonly, this occurs on the side of the neck, under the arm or in the groin region. Sudden and unexplained weight loss is also a common early warning sign of non-Hodgkin lymphoma.

Other common non-Hodgkin lymphoma symptoms include:

  • Fever
  • Night sweats (often soaking the sheets) and/or chills
  • Persistent fatigue, lethargy, weakness
  • Loss of appetite, nausea, vomiting
  • Abdominal pain or swelling, or a feeling of fullness
  • Skin rash or itchy skin
  • Coughing or shortness of breath
  • Headaches
  • Difficulty moving parts of the body
  • Pain in the chest, abdomen or bones for no known reason

When the lymph system detects an infection, lymph nodes produce more immune cells,which may cause them to swell. Swollen lymph nodes, a fever and night sweats may also be symptoms of the cold and flu. However, unlike the cold and flu, non-Hodgkin lymphoma symptoms typically do not go away. If you have symptoms that persist for more than two weeks, or symptoms are recurring and becoming more intense, you should see your doctor.

Sudden and dramatic weight loss, such as losing more than 10 percent of your normal weight in less than six months, is also a sign that deserves medical attention. Sometimes, a patient’s only sign of non-Hodgkin lymphoma is constant fatigue.

Symptoms based on location and type

Symptoms may be different depending on the location and type of non-Hodgkin lymphoma. For example, lymphoma that develops in the abdominal area may cause belly pain or swelling. Cancer in the stomach or intestines may come with belly pain, nausea or vomiting. If the spleen is affected, such as in mantle cell lymphoma, patients may experience feelings of fullness or poor appetite due to the enlarged spleen putting pressure on the stomach.

Lymphoma in the chest, such as primary mediastinal large B-cell lymphoma, may put pressure on important areas such as the windpipe or the superior vena cava, a large and crucial vein. A tumor that presses on the windpipe may lead to symptoms such as coughing, difficulty breathing and chest pain. Pressure on the superior vena cava may result in symptoms such as difficulty breathing, swelling and color changes in the head, arms and upper chest.

Lymphoma that occurs in the central nervous system, such as the brain and spinal cord, may result in double vision, numbness in the face and difficulty speaking. Primary brain lymphomas may come with headaches, muddled thinking, weakness, changes in personality and seizures. Lymphoma in the skin may be apparent to the eye and show up as masses or bumps under the skin that are itchy, red or purple.

Also, some lymphomas occur in the female reproductive system, such as the ovaries, uterus, cervix, vagina and vulva. Lymphoma in this region may cause a mass in the pelvis that may be seen or felt, as well as pelvic pain or pressure, vaginal bleeding and discharge.

Other types of lymphoma

All lymphomas start in a particular type of cell called a lymphocyte. Some affect B lymphocytes (B cells), while others affect T lymphocytes (T cells) and, rarely, natural killer (NK) cells. While most lymphomas start in B cells, a minority—less than 15 percent of all non-Hodgkin lymphomas—are T-cell lymphomas, and fewer than 1 percent affect natural killer cells.

T-cell lymphomas and natural killer T-cell lymphomas may have different symptoms depending on the subtype and location of the cancer. Below are some of the different types of T-cell lymphomas and their associated symptoms.

  • Peripheral T-cell lymphoma, not otherwise specified (PTCLNOS) often causes symptoms such as fever, night sweats and unintentional weight loss.
  • Anaplastic large cell lymphomas (ALCL) may come with symptoms such as fever, backache, painless swelling of lymph nodes, poor appetite, itchy skin, rashes and fatigue.
  • Angioimmunoblastic T-cell lymphoma (AITL) often causes symptoms such as fever, night sweats, rashes and itchy skin.
  • Cutaneous T-cell lymphoma (CTCL) may cause skin changes, which may include flat, rash-looking patches; thick, raised and itchy eczema-like plaques; and raised bumps.
  • Aggressive natural killer (NK) cell leukemia may come with symptoms such as fever, yellowing of the skin (jaundice), swollen lymph nodes, swelling of the liver or spleen, and potentially skin changes.
  • Extranodal natural killer (NK) T-cell lymphoma, nasal type, often causes a blocked nose, bloody nasal discharge, swelling of the cheek, sore throat, hoarseness, fever and weight loss.

SVC syndrome

Lymphomas may occur anywhere in the network of lymph vessels throughout the body. Tumors or swollen lymph nodes in the chest area may squeeze the superior vena cava, a major vein feeding into the heart.

When this happens, blood from the head, arms and chest may get backed up and cause swelling, or turn the skin to a bluish-red color. This condition may become severe and require medical treatment, especially if the oxygen supply to the brain becomes restricted.

B symptoms

B symptoms are a group of general symptoms that may be indicators of an aggressive lymphoma. B lymphoma symptoms are often identified during the staging process to help determine an overall prognosis and guide treatment decisions.

The staging process generally measures the extent and spread of cancer using the numbers 1 through 4. The staging of non-Hodgkin lymphoma is unique in that it also assigns the letters A and B to each stage. The letters indicate whether certain symptoms are present.

The letter B indicates that the patient is experiencing one or more of the following symptoms: drenching night sweats, fever or unexplained weight loss. If none of these symptoms has developed, the letter A is used. B symptoms may be signs of a more advanced cancer.

Conditions that may cause similar symptoms

Having one or a couple of symptoms associated with non-Hodgkin lymphoma doesn’t mean that you have cancer. Many of these symptoms, particularly the swelling of lymph nodes, are often due to more common problems.

Inflammation in the lymph nodes and other lymphoma-like symptoms may be caused by different types of infections, according to an article in The Oncologist. These infections include those caused by streptococcal bacteria (which causes strep throat and other illnesses) and viruses like the Epstein-Barr virus (which causes mononucleosis and other illnesses). Autoimmune disorders such as rheumatoid arthritis, lupus and Sjogren's syndrome may also cause enlarged lymph nodes.

Drug hypersensitivity reactions (allergic or abnormal responses to medicines) may cause lymphoma-like symptoms including lymph node swelling, fever, rash and high white blood cell counts. Anticonvulsants, penicillins and aspirin are some examples of drugs that are more likely to cause these types of reactions.

Rarer conditions may also be confused with lymphoma, such as:

  • Sarcoidosis
  • Amyloidosis
  • Kikuchi’s disease
  • Rosai-Dorfman disease
  • Castleman’s disease
  • Lymphomatoid granulomatosis
  • Lymphomatoid papulosis

What to do if you notice symptoms

If you're experiencing symptoms that may indicate non-Hodgkin lymphoma, it’s important to see a doctor who may help you discover the cause. At the appointment, your doctor will likely ask questions about your symptoms and decide how to proceed.

The doctor may want to conduct a physical exam focused on feeling for swelling or abnormalities in your lymph nodes and other areas that are commonly affected by lymphoma. Depending on your symptoms, your doctor may recommend a blood test or other tests. At this stage, when you’re experiencing lymphoma-like symptoms but are unsure of the cause, some of the questions you may want to ask your doctor include:

  • What are some of the potential causes of my symptoms?
  • How will you determine the cause of my symptoms?
  • How will you determine whether or not I have lymphoma?
  • What kind of tests may I need?

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