Non-Hodgkin Lymphoma Symptoms
Non-Hodgkin lymphoma (NHL) symptoms can vary widely depending on the part of the body affected and the subtype of the disease. Some signs may be subtle, while others can impact daily life. In addition, symptoms often differ between indolent (slow-growing) forms, where changes may develop gradually, and aggressive (rapidly growing) types, which tend to cause noticeable symptoms more quickly. Knowing what to watch for can help you recognize changes early and seek medical care promptly.
Non-Hodgkin lymphoma early symptoms
Early signs of non-Hodgkin lymphoma can be subtle and easily overlooked. Recognizing them is important because early diagnosis can improve treatment outcomes. Common early symptoms include:
- Painless swelling of lymph nodes in the neck, armpit, or groin
- Fatigue or low energy
- Mild fevers
- Unexplained weight loss
- Night sweats
Non-Hodgkin lymphoma late symptoms
As non-Hodgkin lymphoma progresses, symptoms may become more noticeable and affect daily life. These late symptoms often indicate that the disease is advancing and may require urgent evaluation. They include:
- Persistent pain in the neck, arms, abdomen, or chest
- Severe fatigue
- Shortness of breath
- Weakness or numbness in limbs
- Confusion or personality changes
Non-Hodgkin lymphoma subtype-specific symptoms
Different types of NHL can show up with their own set of symptoms. These differences can help guide your care team toward the correct diagnosis and treatment. Examples include:
- Diffuse large B-cell lymphoma (DLBCL, aggressive NHL): Rapidly enlarging lymph nodes, fever, night sweats, weight loss and abdominal pain
- Follicular lymphoma (indolent NHL): Painless swelling of lymph nodes that may come and go
- Burkitt lymphoma (highly aggressive NHL): Rapid tumor growth in the jaw or abdomen, abdominal swelling or pain and possible intestinal obstruction
- Primary CNS lymphoma: Headaches, memory problems, personality changes, limb weakness or numbness and seizures
- T-cell lymphomas: Skin rashes or nodules, severe itching and swelling in affected areas
What does non-Hodgkin lymphoma feel like?
Understanding how NHL symptoms feel can help patients recognize changes in their body that might need medical attention. Typical experiences may include:
- Swollen lymph nodes that feel firm but not painful, often described as rubbery
- Fatigue that feels overwhelming and persistent, not relieved by sleep
- Night sweats that soak clothing or bedding without fever
- Pain from tumor growth that may be dull, aching, or pressure-like, depending on location
- Decrease in appetite
These symptoms do not always mean you have non-Hodgkin lymphoma. However, it is important to discuss any symptoms with your doctor, since they may also signal other health problems.
Other conditions with similar symptoms
Because many NHL symptoms are nonspecific, they can be caused by other conditions. Knowing this helps families avoid unnecessary anxiety while ensuring timely medical evaluation. Conditions that may mimic NHL include:
- Infections
- Autoimmune diseases
- Benign lymph node enlargement
When to see a doctor
Prompt evaluation by a health care provider is crucial if certain red flags appear. Early assessment can lead to quicker diagnosis and more effective treatment. Seek care if you notice:
- Rapidly enlarging lymph nodes
- Severe shortness of breath or chest pain
- High fevers that do not respond to medication
- Sudden neurological changes (confusion, severe headaches)
- Rapid, significant weight loss without trying to lose weight
Swollen lymph nodes and other symptoms of lymphoma
Almost everyone will experience a swollen lymph node at some point. That’s because these structures are designed to filter germs and other impurities from the body.
Lymph nodes become swollen as they trap viruses, harmful bacteria and damaged cells, then attempt to destroy them with lymphocytes, the white blood cells that fight off infection.
But swollen lymph nodes can also be a sign of cancer, including a type of blood cancer called lymphoma. So, when are swollen lymph nodes just a sign of infection, as opposed to a symptom of lymphoma? We checked in with lymphoma and myeloma specialist Felipe Samaniego, M.D.
How often do swollen lymph nodes appear as the first sign of lymphoma in undiagnosed patients?
That’s kind of hard to say. By the time we see most patients here at MD Anderson, they’ve already been diagnosed elsewhere or been told there’s a strong possibility that whatever it is that they have is cancer.
That being said, in the greater community, swollen lymph nodes among undiagnosed patients tend to fall into one of two categories:
- Lymph nodes that patients notice or that a doctor sees or feels during a physical exam, like swollen lymph nodes in neck, armpit or groin areas.
- Lymph nodes that are found during an MRI or a CT scan because the patient is complaining of something else, such as chest pain or a lump in their breast
What are the most common places in the body where swollen lymph nodes occur as a sign of lymphoma?
Most will be in the neck, because the mouth and throat — or oropharyngeal tract — are the main gateway for things to get inside our bodies. So, we need to have a good defense system there.
But patients can find swollen lymph nodes in other places, too — especially where they lie close to the skin’s surface, like the groin area (where the leg meets the trunk) and the axilla, or armpit.
Lymphoma is actually detected pretty frequently during mammograms, because the field of view also covers the armpit, so it reveals swollen lymph nodes in that area.
Occasionally, patients may develop swollen lymph nodes all over their bodies, but this is relatively rare.
Is there a way to tell the difference between cancerous swollen lymph nodes and non-cancerous ones?
Anyone who’s really concerned about a swollen lymph node should go see their doctor. But here are some general guidelines:
- Size: Lymph nodes are made to change in size because they’re doing a job. They grow larger as the number of cells caught inside of them increases and shrink back down to normal as that number drops. But the normal size of an average lymph node is under 1.5 centimeters, or about ¾ of an inch or smaller. So, if something is larger than that or growing continuously, it needs to be checked out.
- Age: Infections are a frequent cause of swollen lymph nodes among young people. So, if you’re a teen or a college student, my first thought would be something like strep throat or mononucleosis. Cancer is more likely in older people, though I’d still want to rule out an infection first. Even among older groups, probably less than half the people who have swollen lymph nodes will have them because of cancer.
- Consistency: Press the tip of your nose with your finger and you’ll have a pretty good idea of what a typical lymph node should feel like. Tumors tend to be harder and more solid, like what you’ll feel if you push on your chin with your finger.
- Sensitivity: Some people think cancer always hurts, but that’s not true. Tenderness tends to be a sign of an infectious process, because the immune system has been challenged. But lymph nodes that are swollen due to lymphoma are usually not painful.
What are other common symptoms of lymphoma?
In lymphoma’s earliest stages, patients often report itchy, inflamed skin or unexplained rashes. In more advanced cases, where patients have large tumors, we start seeing weight loss, fevers, night sweats, and fatigue. Some experience painful muscle aches after drinking alcohol, too, though that is fairly unusual.
When should someone see their doctor about a swollen lymph node?
Swollen lymph nodes usually just mean your body is working the way it’s supposed to. But if a swollen lymph node keeps getting bigger or doesn’t resolve on its own within two weeks, get it checked out.
Request an appointment at MD Anderson online or by calling 1-877-632-6789.