Non-Hodgkin lymphoma (NHL) usually announces itself through enlarged lymph nodes or a mass outside the nodes, and the symptoms follow from where that disease sits and how much bone marrow it crowds out.
Nodal disease and its local effects
The most common finding is lymphadenopathy, meaning enlarged lymph nodes, and the enlarged nodes are typically painless. Because nodes lie close to other structures, an enlarging mass can compress whatever lies beside it:
- superior vena cava compression — shortness of breath and facial oedema
- biliary tract compression — jaundice
- ureter compression — hydronephrosis
- bowel compression — vomiting and constipation
Organ involvement and systemic symptoms
Disease beyond the nodes produces splenomegaly and hepatomegaly (an enlarged spleen and liver). Constitutional B symptoms — fever, night sweats and unintentional weight loss — reflect the systemic effect of the tumour rather than its local mass. When the bone marrow is involved it is gradually replaced by lymphoma cells, so the normal blood counts fall and cytopenias (low counts of one or more blood cell types) appear.