Lymphomas are quite common cancers. Lymphoma is a tumor that originates from lymphocytes. Lymphocytes are a type of white blood cell that is an integral part of the immune system. They help protect against many harmful organisms that enter the body. Developing lymphoma means that an abnormal lymphocyte starts to increase. Lymphomas are classified into Hodgkin and non-Hodgkin lymphomas. The name Hodgkin refers to the scientist who first described the disease, Dr. Thomas Hodgkin. Later on, another type of lymphoma was described and was called non-Hodgkin lymphoma. Because there's no screening test for lymphoma, people who are at risk of developing non-Hodgkin lymphoma-people with low immunity, human immunodeficiency virus (HIV) infection and previous treatment against cancer-should be aware of the symptoms because detecting the tumor early may lead to a better prognosis.
Lymph node enlargement is the most common symptom of non-Hodgkin lymphoma. When the lymphocytes start to reproduce inside the lymph node, the size of the lymph node will increase. The patient may notice this enlargement as a lump under the skin. One main difference between an enlarged lymph node due to non-Hodgkin lymphoma and one due to an infection is that the latter may be tender. What makes this symptom so typical is the fact that lymph nodes are present all over the body. It's easier to notice them at sites where the lymph nodes are closer to the surface of the skin, like the neck and armpits. They can also be seen in the groin and abdomen. Like most tumors, this increase in size is not accompanied by pain.
If the non-Hodgkin lymphoma starts in the spleen or the liver, then patients may notice an enlarged spleen or liver. Lymphoma may originate from lymphoid tissue in an abdominal organ. As the size of the tumor increases, fluid may start building up, and the abdomen may become swollen and tender. The more the tumor grows, the more pressure is put on the surrounding structures. Increasing the pressure on the stomach may lead the patient to experience abdominal pain, nausea, decreased appetite, and early satiety, which is feeling full or heavy after eating only a small meal. Increasing the pressure on the intestines may lead to decreased bowel movements, nausea, vomiting, and abdominal pain. The condition may even progress to intestinal perforation.
Non-Hodgkin lymphoma patients usually experience a fever, which might be greater than 38 degrees Celsius. This temperature is not due to any bacterial or viral infection. The fever doesn't usually follow a particular pattern. In some patients, however, it increases throughout one week and then decreases throughout the following week, and so on. The cause of this cyclic pattern is not well understood, but some speculate it has something to do with the inflammatory chemicals and proteins inside the body called cytokines.
Weight loss is common among cancer patients. In fact, 40 percent of cancer patients experience unexplained weight loss. Sometimes it can be the first symptom noticed by the patient. The patient might lose up to one-tenth of their total weight over six months or less. There is no precise cause for this drastic weight loss, but it usually starts with loss of appetite. Some of the other factors contributing to it include nausea, vomiting, pain, and depression. In advanced cases, the weight loss progresses to cachexia, which is a combination of weight loss and muscle wasting.
Another symptom of non-Hodgkin lymphoma is night sweats accompanied by shivering. One of the main characteristics of these sweats is that they are drenching. Drenching sweats mean that most patients wake up to find their clothes soaked and the sheets of their bed thoroughly wet, even if they weren't sleeping in a hot room. Increased sweating can also happen during the day, while the patient is awake, but night sweats are more common. The presence of fever, weight loss, and night sweats indicates a more advanced stage of the disease. They are called B symptoms and suggest that the illness is starting to affect the constitution of the body and not just causing a local affliction.
Non-Hodgkin lymphoma patients can feel exhausted and weak. It can be during or after physical activity, but it can also be unrelated to activity. Patients may feel unable to carry out regular daily tasks. This kind of fatigue doesn't improve after resting or sleeping. It may be due to the mere presence of the lymphoma, which drains the body's energy sources or releases certain proteins or cytokines. It can also be due to other causes, including stress, anxiety, lack of sleep, or anemia. Fatigue caused by cancer can last for years and may persist even after treatment.
Non-Hodgkin lymphoma may arise in the skin. Manifestations include a red or purple lump and itchy skin. When the tumor starts in the skin, the manifestations tend to differ according to the type of malignant lymphocyte involved; it can either be a T-cell lymphocyte or a B-cell lymphocyte. T-cell lymphoma skin lesions include flat red patches, thick, raised plaques, and sometimes the skin of the palms and soles becomes thickened. On the other hand, B-cell lymphoma skin lesions include a reddish rash or nodules with a raised smooth surface. The skin lesions of lymphoma may become complicated by infection and ulceration.
When lymphoma starts in the chest, it can either be a lymph node or in the thymus. The thymus is an organ located in front of the heart and behind the sternum. As lymphoma grows in the chest, it starts compressing the trachea (known as the windpipe). Compression of the trachea may lead to a cough, chest pain, and difficulty breathing. Lymphoma arising in the chest may also compress the nearby superior vena cava (SVC), which is the vein responsible for delivering the blood leaving the head and arms back to the heart. This compression might lead to a cough, chest pain, difficulty in swallowing, enlargement of the veins in the head and neck, and bluish discoloration in the head and arm.
It's rare for a lymphoma to start in the brain. When it does, it usually occurs in patients with very low immunity, typically acquired immunodeficiency syndrome (AIDS) patients. Lymphoma in the brain will generate an array of neurological symptoms that include headaches, seizures, personality changes, double vision, vertigo, speaking difficulties, loss of monocular vision, facial numbness, weakness, progressive dementia that causes many cognitive abnormalities, and decreased ability to think and remember.
In some people, lymphoma will be present in the bone marrow, which is the tissue inside the largest bones that is responsible for producing your blood cells. Having lymphoma in your bone marrow can lead to decreasing counts of the different blood cells. Low numbers of white and red blood cells can manifest as follows: increased risk of infections as the body becomes unable to fight the various organisms; anemia, which causes fatigue, weakness, and shortness of breath due to low red blood cells; and nasal bleeding, bleeding gums, long or heavy periods, and bruising due to low platelets.
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