Lymphoma Signs and Symptoms

Common Presenting Signs

The American Academy of Otolaryngology-Head and Neck Surgery suggests that lymph nodes that are firm, non-tender, and fixed/reduced in mobility are more suspicious for malignancy, and lymph nodes larger than 1.5 cm in any cervical location should raise suspicion for malignancy 1
The National Comprehensive Cancer Network recommends that enlarged spleen or liver may be detected on physical examination and confirmed by imaging, and mediastinal mass may be detected on chest imaging, particularly in Hodgkin lymphoma 2, 3
Painless enlarged lymph nodes are the most common presenting sign, occurring in over 60% of patients with lymphoma, particularly in the cervical region, according to the National Comprehensive Cancer Network and Praxis Medical Insights 4, 2

The National Comprehensive Cancer Network and Praxis Medical Insights state that unexplained fever >38°C (>101°F) and unexplained loss of >10% body weight within 6 months are B symptoms that may indicate lymphoma 2, 5
Drenching sweats that require changing clothes or bedding are also a B symptom, as noted by Praxis Medical Insights 5
Persistent tiredness not relieved by rest and generalized or localized itching without rash are other common symptoms, according to Praxis Medical Insights and the National Comprehensive Cancer Network 4, 2

The National Comprehensive Cancer Network and Journal of Clinical Oncology recommend using the Ann Arbor staging system for classification, with stages I-IV based on extent of disease, and "A" indicates absence of systemic symptoms, while "B" indicates presence of B symptoms 2, 3, 6
Excisional biopsy is the preferred diagnostic method, and fine-needle aspiration alone is insufficient, as stated by the Journal of Clinical Oncology 3
PET/CT scanning is the standard for assessment and staging in most lymphomas, according to the Journal of Clinical Oncology 3

The American Academy of Otolaryngology-Head and Neck Surgery notes that immunocompromised patients are at higher risk for lymphoma development and may present with more aggressive disease 1
Annals of Oncology reports that in follicular lymphoma, spontaneous regressions occur in 10-20% of cases 7, 8
Hodgkin lymphoma has a bimodal age distribution (young adults 20-40 years and older adults >55 years) and more commonly presents with B symptoms, as stated by Praxis Medical Insights 4

The European Society for Medical Oncology recommends checking lactate dehydrogenase (LDH) levels, as elevated LDH is a significant marker for lymphoma, in patients with suspected lymphoma 9, 10
Elevated acid uric levels are also associated with lymphoma, according to the European Society for Medical Oncology 9, 10