A sore throat is a common experience, but if it lingers, it can cause concern about more serious conditions. Lymphoma is a cancer that originates in the lymphatic system, a network of tissues and organs composed primarily of lymph nodes. Because many lymph nodes are clustered in the neck, lymphoma can, in rare instances, be the underlying cause of a persistent sore throat. While most sore throats are due to benign infections, understanding how lymphoma affects the throat provides context for when to seek medical attention.
The Direct Connection: How Lymphoma Affects the Throat
The lymphatic system is distributed throughout the body, with lymph nodes particularly concentrated in the neck area, close to the pharynx and tonsils. Lymphoma involves the uncontrolled growth of lymphocytes, which accumulate in the lymph nodes, causing them to swell (lymphadenopathy). Enlarged cervical lymph nodes can become large enough to create pressure on surrounding throat structures and nerves. This physical compression manifests as pain, discomfort, or a sensation of a lump. The discomfort results from the bulk of the diseased tissue pressing on sensitive areas, not traditional inflammation.
In addition to lymph node swelling, lymphoma can also originate directly in the throat structures, a phenomenon called primary extranodal involvement. The tonsils, masses of lymphoid tissue, are a common site for this presentation. When lymphoma cells multiply within the tonsil, it leads to tonsillar lymphoma, causing the tonsil to become enlarged, often unilaterally. This results in a chronic, localized sore throat and can make swallowing difficult.
Distinguishing Persistent Symptoms from Common Infections
A sore throat resulting from a common cold or strep infection is typically acute, meaning it has a sudden onset and resolves completely within a week to ten days, often with or without treatment. In contrast, a sore throat related to lymphoma is characterized by its persistence and gradual worsening over an extended period, often lasting weeks or months without improvement. Unlike infectious pharyngitis, which may feature pus or marked redness (exudate) on the tonsils, the throat pain associated with lymphoma often lacks these acute signs of infection.
A significant differentiator is the presence of systemic symptoms, sometimes referred to as “B symptoms.” These symptoms indicate the cancer is causing effects throughout the body. They include drenching night sweats, unexplained fevers, and unintended weight loss of 10% or more of body weight over six months. When a persistent sore throat is accompanied by any of these B symptoms, the suspicion for lymphoma or another systemic illness increases considerably.
Common infections cause lymph nodes to swell as part of the immune response, but these nodes usually shrink back to normal size once the infection is cleared. Lymphoma-related lymphadenopathy, however, is characteristically persistent, and the nodes may continue to grow rather than resolving. While most enlarged nodes are painless, those that grow rapidly or press on nerves can cause discomfort, contributing to the throat pain.
Next Steps: When to Consult a Doctor
A sore throat is an extremely frequent symptom, and the vast majority of cases do not indicate lymphoma. However, certain “red flag” indicators should prompt a professional evaluation. Any sore throat that lasts for longer than two weeks, or one that is continuously getting worse, warrants a medical examination.
It is also important to seek professional advice if a persistent sore throat is coupled with any of the B symptoms, such as unexplained fever, drenching night sweats, or significant, unintentional weight loss. The presence of a persistent, non-tender lump in the neck, especially one that does not resolve after an apparent infection clears, is another clear reason to see a doctor.
A physician will typically begin with a thorough physical examination and may order basic blood tests, such as a complete blood count (CBC), or a throat swab to rule out common bacterial causes like strep. If the initial assessment raises suspicion for lymphoma, the doctor may recommend further diagnostic steps, which could include imaging studies or a biopsy of the enlarged lymph node or tonsil. The definitive diagnosis of lymphoma requires professional testing and is not something that can be determined through self-assessment.