In many instances, lymphoma is not diagnosed until a patient discovers an unusual lump at the site of an emerging tumor, prompting a doctor visit. Having one or more of the other symptoms associated with lymphoma may also motivate a patient to seek a diagnosis. People at elevated risk for developing lymphoma (patients with HIV/AIDS, transplant patients, patients who have been treated for other cancers, and those with autoimmune diseases) should get regular checkups to improve their chances of early detection of lymphoma.
Besides swollen lymph nodes, symptoms may include:
- unexplained weight loss
- recurrent fevers
- soaking night sweats
- itching or discoloration of the skin
Because there are so many types of lymphoma, which may affect so many different areas of the body, any number of other symptoms may be encountered. These include coughing or trouble breathing (in the case of lymphoma in the chest) or even swelling and discoloration (bluish-red color) in the head, upper arms, or chest due to vascular congestion from tumor growth. Lymphomas in the brain (primary brain lymphomas) may cause personality changes, inability to think clearly, partial loss of muscle control, or even seizures.
In some instances lymphoma spreads to the bone marrow, where it may affect the body’s production of various types of blood cells. When white blood cell counts plummet, this form of lymphoma may affect the body’s ability to fight off infection, resulting in frequent, possibly severe infections. If red blood cell production suffers, the patient could develop anemia, which is experienced as fatigue. If blood platelet production drops, unusual bruising, or even bleeding, may result. Any of these symptoms warrant examination by a physician. The symptoms of NHL tend to be relatively non-specific, however, so physicians often attempt to rule out other possible explanations first.
Upon consultation for any of these complaints, doctors may physically examine the patient for the presence of any bumps or swellings. The physician visually examines and explores swellings by touch, to get a sense of the shape, size, and tenderness of the area. Simple infections are the most common explanation for lymph node swelling, so a physician may recommend waiting to see if the swelling subsides within a few weeks. She may also prescribe antibiotics to see if this helps clear the suspected infection and reduces swelling.
If the swelling remains unchanged, or enlarges, the physician will probably order a tissue biopsy of the area. Biopsy involves removing either the entire affected node or a small sample of the affected tissue. In the case of excisional or incisional biopsy, which can be performed on an outpatient basis, the area is first numbed by injection of local anesthetic at the site. Using a scalpel, the doctor will then remove the entire node (in the case of excisional biopsy), or a portion of a large tumor (incisional biopsy). A third option involves fine needle aspiration or core needle biopsy. These less invasive methods employ thin needles guided into the site, which remove a small sample of cells from the suspected tumor. The tissue sample obtained from any of these procedures will then be sent to a laboratory for microscopic analysis. Such analysis is the only way to diagnose lymphoma definitively.