Lymphomalife.net

Many people with indolent non-Hodgkin's lymphoma (NHL) don't notice any symptoms when they are first diagnosed.

In fact, it is quite common for indolent NHL to be first discovered as the result of a physical examination by the doctor or an investigation for some other condition, such as a blood test or a chest X-ray.

However, you will probably experience some or all of the symptoms described here during your time with NHL.

The most common symptom of NHL is a painless swelling in the neck, armpit or groin. Many other symptoms often occur, including feelings of being generally unwell. But all the symptoms of NHL can be put down to other causes. Using tests to confirm the diagnosis is therefore very important when the doctor is deciding whether you have NHL.

Swellings

The swellings, or tumours, that are caused by non-Hodgkin’s lymphoma (NHL) are known as lymphomas. They are often first noticed in the neck, collarbone region, armpits or groin. They are caused by affected white blood cells (cancerous lymphocytes) collecting in the lymph nodes (or glands). 

The lymph nodes also swell up when people have a normal cold or infection. So it is important to remember that swollen lymph nodes alone do not necessarily mean you have lymphoma. The swelling will go down when the infection is over. The difference with NHL is that the swelling goes on for much longer. Doctors sometimes call this lymphadenopathy.

Cough, chest pain or shortness of breath

Many symptoms of non-Hodgkin’s lymphoma (NHL) can depend on where the swellings have formed. For example, chest pain and shortness of breath may happen if the lymph nodes in a gland called the thymus contain a lymphoma. This gland is near the heart and it may swell up and press on the heart causing chest pain, or on the windpipe causing shortness of breath.

Completely different symptoms can occur if the swelling is in another part of the body, outside the lymph nodes. For example, lymphoma in the stomach or intestines might cause abdominal pain, indigestion or diarrhoea.

Drenching night sweats tiredness, and loss of appetite

The white blood cells (lymphocytes) that are affected by non-Hodgkin’s lymphoma (NHL) are an important part of the immune system – the body’s natural defence against infection. So some symptoms happen because your immune system is not functioning properly and your body is finding it harder than normal to fight off infections caused by viruses or bacteria. These include tiredness, drenching night sweats and loss of appetite.

Feeling generally unwell

Feeling unwell is also common when you have non-Hodgkin’s lymphoma (NHL). And many of the specific symptoms of NHL can be thought of as general feelings of illness. These include:

• Recurrent or persistent, unexplained fevers (with body temperature over 38°C)
• Night sweats, which may drench nightclothes and sheets
• Unintended weight loss (defined as losing more than 10% of the body weight in 6 months)
• Severe and persistent fatigue or tiredness
• Decreased appetite
• Other general symptoms that people with NHL may experience include:
• Breathlessness or cough
• Itchiness that is persistent and may be felt all over the body.

The first three of these symptoms – fevers, night sweats and weight loss – are often used in the staging of NHL and are sometimes called 'B symptoms'.
The B symptoms – fevers night sweats and weight loss – are important for staging NHL

Find out more about the diagnosis and staging of non-Hodgkin’s lymphoma