Lymphoma is a cancer that originates within the lymphatic system, the body’s network of tissues, vessels, and organs designed to combat infection. The disease begins when a type of white blood cell, called a lymphocyte, undergoes malignant change and multiplies uncontrollably. Since the lymphatic system is widespread, comprising fluid, vessels, and nodes throughout the body, the signs and symptoms of lymphoma can be varied.
Localized Physical Manifestations
The most common initial indication of lymphoma is an observable swelling of the lymph nodes, medically termed lymphadenopathy. These enlarged nodes are felt as lumps just beneath the skin, typically presenting where nodes are numerous and close to the surface. Common sites include the neck, the armpit (axilla), and the groin.
Lymphoma-related lymphadenopathy is usually painless, unlike the tenderness associated with nodes swollen due to infection. The cancerous nodes often feel firm and rubbery to the touch. Unlike temporary swellings, they persist and may continue to grow over time, including swelling above the collarbone (supraclavicular lymphadenopathy).
When cancerous nodes are located deep within the body, they may not be visible but cause symptoms by affecting surrounding structures. For instance, masses in the chest cavity (mediastinum) can press on airways or major blood vessels. This compression leads to symptoms such as a persistent cough, chest pain, or difficulty breathing.
Generalized Systemic Indicators
Lymphoma can cause systemic symptoms that affect the entire body, often referred to as “B symptoms.” These three specific indicators are important for disease staging and prognosis. They arise from the body’s reaction to the cancerous cells and the signaling molecules they release.
An unexplained fever is one indicator, often persistent or recurring without an identifiable infection. This may be a low-grade fever or a temperature of 100.4°F (38°C) or higher that lasts for multiple days or weeks. The fever is thought to result from the body’s inflammatory response to abnormal cell growth.
Drenching night sweats are characterized by severe perspiration during sleep. These episodes are significant enough to soak through clothing and bedding, often requiring a change of sheets. This symptom is linked to the release of chemical messengers by the cancer cells.
The third systemic indicator is unexplained weight loss, which must meet a specific threshold to be classified as a B symptom. This involves losing 10% or more of body weight over six months without dieting or increased physical activity. This loss of mass is a sign of high metabolic activity within the cancer cells.
Symptoms Related to Organ and Tissue Involvement
Lymphoma produces a wide array of symptoms depending on where malignant lymphocytes accumulate or spread outside the lymph nodes. Persistent fatigue and weakness not relieved by rest is a common complaint. This tiredness is associated with anemia, a low red blood cell count often resulting from bone marrow involvement.
Involvement of the bone marrow, the primary site of blood cell production, can manifest as increased susceptibility to infections, since normal white blood cell production is suppressed. A reduced platelet count due to marrow infiltration may also result in easy bruising or abnormal bleeding.
When the disease affects abdominal organs, specific symptoms emerge. An enlarged spleen or liver can cause abdominal discomfort or swelling. An enlarged spleen may press on the stomach, leading to a feeling of fullness after eating a small amount of food and reducing appetite.
Lymphoma affecting the skin (cutaneous lymphoma) can cause generalized or localized itching (pruritus), or present as red or purple lumps and rashes. In rare instances, lymphoma may also affect the central nervous system. When this occurs, symptoms can include chronic headaches, seizures, or changes in cognitive function and personality.