What Are the Warning Signs of Lymphoma?

Lymphoma is a cancer of lymphocytes, which are cells in the body's immune system. Lymphoma warning signs include swollen lymph nodes, fever, chills, weight loss, shortness of breath, drenching night sweats, tiredness, and swelling in the abdomen.

Lymphoma is a cancer of certain cells that are part of the body's immune system called lymphocytes. When lymphocytes become abnormal and grow out of control, it is lymphoma. 

There are several different types of lymphoma. 

• Hodgkin lymphoma (Hodgkin disease) 
• Non-Hodgkin lymphoma (sometimes called NHL, or just lymphoma) 
• Childhood Non-Hodgkin lymphoma
• Skin lymphomas (cutaneous lymphomas)
• Waldenstrom macroglobulinemia

Symptoms that are warning signs of lymphoma may include: 

• One or more large, swollen lymph nodes under the skin
  • Usually are not painful
  • Often found in the side of the neck, groin, or armpit
  • Cough or trouble breathing (from swollen lymph nodes around the lungs)
• Fever
• Chills
• Weight loss without trying
• Shortness of breath
• Drenching night sweats that soak your clothes
• Itching skin
• Tiredness (fatigue)
• Swelling in the abdomen

Other symptoms of lymphoma may include:

• Loss of appetite
• Chest pain
• Severe or frequent infections
• Feeling full after only a small amount of food
• Chest pain or pressure
• Easy bruising or bleeding

Causes of lymphoma include:

• Genetic mutations
• Changes in the immune system
  • Immune deficiencies (due to inherited conditions, certain drug treatments, organ transplants, or HIV infection) 
  • Autoimmune diseases 
  • Chronic infections 

Risk factors for developing Hodgkin lymphoma and non-Hodgkin lymphoma include:

• Age: most common in early adulthood (especially in a person’s 20s) and late adulthood (after age 55) for Hodgkin lymphoma and over 60 years for non-Hodgkin lymphoma
• Gender: both tend to occur more often in males than in females, but there are some types of NHL that are more common in women
• Family history
• Weakened immune system: human immunodeficiency virus (HIV), taking medications to suppress the immune system after organ transplant, and autoimmune diseases, and some genetic (inherited) syndromes, such as ataxia-telangiectasia (AT) and Wiskott-Aldrich syndrome
• Epstein-Barr virus (EBV) (Hodgkin lymphoma)

Additional risk factors for developing non-Hodgkin lymphoma include:

• Race, ethnicity, and geography: more common in Caucasians than African Americans and Asian Americans, and more common in developed countries
• Exposure to certain chemicals and drugs such as benzene, certain herbicides and insecticides, some chemotherapy drugs used to treat other cancers, and certain drugs used to treat rheumatoid arthritis, such as methotrexate and the tumor necrosis factor (TNF) inhibitors
• Radiation exposure: prior treatment with radiation therapy for other cancers and survivors of atomic bombs and nuclear reactor accidents
• Autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus (SLE or lupus), celiac disease, and Sjögren disease 
• Certain infections
• Being overweight/obese
• Breast implants (rare)

Lymphoma is diagnosed with a patient history and physical exam, and tests including:

• Lymph node biopsy
• Bone marrow aspiration and biopsy 
• Imaging tests
  • Computerized tomography (CT) scan
  • Positron emission tomography (PET) scan
  • Magnetic resonance imaging (MRI)
  • Ultrasound
  • X-rays
• Blood tests
  • Complete blood count (CBC) 
  • Tests to check liver and kidney function 
  • Erythrocyte sedimentation rate (ESR) 
  • HIV test
  • Hepatitis B and C virus test
• Echocardiogram (an ultrasound of the heart) or a MUGA scan 
• Lumbar puncture (spinal tap)
• Lung (pulmonary) function tests (PFTs) 

Treatments for lymphoma may include one or more of the following:

• Chemotherapy 
• Immunotherapy 
• Targeted therapy
• Radiation therapy 
• Bone marrow transplant (also called stem cell transplant) 
• Palliative and supportive care