Brenda Spriggs, MD, MPH, MBA
Lymphoma is form of cancer of the lymphocytes, a type of white blood cell. The two broad categories of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma. The American Cancer Society reports approximately 74,500 new cases of lymphoma were diagnosed in the United States in 2009; almost 90 percent were non-Hodgkin type. Both types of lymphoma share similar signs and symptoms.
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Swollen Lymph Nodes
Lymphoma cancer cells cause swelling of the lymph nodes. This is usually most noticeable in the armpits, neck and groin because the lymph nodes in these areas are close to the skin surface. Notably, the swollen nodes are not painful or tender.
Unintentional Weight Loss and Loss of Appetite
Unintentional weight loss is a common symptom of lymphoma. Loss of appetite may also occur. Weight loss can sometimes be dramatic.
Fever and Night Sweats
Lymphomas can cause fevers. The fevers often peak at night, causing drenching night sweats--enough so that the bedding and nightclothes become wet.
Chronic fatigue is a common symptom of cancer, including lymphomas. Fatigue persists despite adequate sleep and may get progressively worse with time.
Generalized itching may occur before any of the other symptoms of lymphoma. In some cases, itching precedes the diagnosis by a year or more.
Nausea, Vomiting and Indigestion
Non-Hodgkin lymphoma can arise outside of the lymph nodes. The stomach is one of the more common sites of extranodal (outside the lymph nodes) lymphoma. Symptoms such as nausea, vomiting and indigestion may occur with stomach lymphoma.
Abdominal Fullness and Pain
Non-Hodgkin lymphoma involving the intestines is called intestinal lymphoma. This type of lymphoma can cause abdominal fullness and pain. Intestinal lymphoma is a particularly aggressive form of the disease.
Chest Pain, Coughing and Breathing Difficulty
Enlarged lymph nodes in the chest due to lymphoma may cause chest pain. Cough may also be triggered. Nodes pressing on the large airways may cause breathing difficulty, due to partial obstruction of airflow. In most people with Hodgkin lymphoma, the lymph nodes from which the cancer arises are in the neck, chest or armpit area. While chest symptoms may suggest Hodgkin lymphoma, non-Hodgkin lymphoma can also arise in chest lymph nodes.
The testicle is a possible site for extranodal non-Hodgkin lymphoma. The involved testicle is typically enlarged, usually without pain.
Hodgkin lymphoma can affect the bone marrow. When the bone marrow is involved in the cancer, bone pain may be present.
Swelling in the Arms or Legs
Markedly enlarged lymph nodes in the armpit or groin may cause fluid buildup in the adjacent limb. Typically, one limb is swollen.
The brain is a possible site for extranodal non-Hodgkin lymphoma. The growing cancer increases pressure within the brain, often causing a persistent headache that gets worse over time. The headache is typically worst in the morning. Lymphoma of the brain is rare. However, Dr. L. Abrey reported in a 2002 review article published in the journal “Hematology,” the incidence of this cancer in the United States increased more than tenfold from 1973 to 1992. Researchers are studying the possible contributing factors to the rising incidence of brain lymphoma.