Signs and Symptoms of Lymphoma

Lymphoma is a group of cancers that affects lymphocytes—a type of white blood cell—in your body’s immune system. The two main types of lymphoma are Hodgkin lymphoma and non-Hodgkin lymphoma (NHL). About 10% of people with lymphoma have the Hodgkin type, while the remaining number of people live with NHL.

The most common symptom of lymphoma is swollen lymph nodes in the neck, upper chest, underarms, stomach, and groin. Other symptoms include fever, fatigue, night sweats, and weight loss. Lymphoma symptoms can sometimes be hard to recognize because they can mimic the symptoms of other, less serious conditions or infections.

Lymphoma may not cause symptoms in the early stages. However, it’s important to learn the warning signs of this type of cancer so you know when to seek medical care. 

Common Symptoms 

The symptoms you experience will depend on whether you have Hodgkin lymphoma or NHL. Most people who receive a diagnosis of lymphoma, regardless of type, have swollen lymph nodes. A swollen lymph node feels like a painless lump under the skin. These lumps are typically located in or near the area of the body where lymphoma first started. 

Other common symptoms of lymphoma include:

• Fever without any other signs of an infection
• Unintentional weight loss
• Fatigue or low energy levels 
• Night sweats that soak your pajamas or sheets

Hodgkin lymphoma typically spreads from one group of lymph nodes to another group of lymph nodes nearby. However, non-Hodgkin lymphoma tends to spread through the lymphatic system in a nonorderly pattern. 

Hodgkin Lymphoma Symptoms 

Fortunately, Hodgkin lymphoma is one of the most curable forms of cancer. Getting screened for lymphoma can also get you an early diagnosis for the condition and improve your treatment options and prognosis (or, how your disease progresses).

It is common to not experience any major symptoms in the early stages of Hodgkin lymphoma. If you begin to notice a swollen lymph node, it will usually feel like a painless lump. As Hodgkin lymphoma spreads, you may notice new lumps developing in other areas of the body. Swollen lymph nodes can also become painful after drinking alcohol.

It’s important to note that most cases of swollen lymph nodes are caused by an infection rather than cancer. This is especially true in children.

A group of common symptoms of Hodgkin lymphoma are known as “B symptoms.” These symptoms include:

• Night sweats: Waking up drenched
• Weight loss: Losing 10% of your body weight over 6 months without meaning to or trying 
• Fatigue: Feeling tired or having low energy levels, despite getting good rest 

Other possible symptoms of Hodgkin lymphoma include:

• Loss of appetite 
• Stomach pain and swelling 
• Cough or shortness of breath
• Itching 

Symptoms of Hodgkin lymphoma vary depending on where your cancer cells occur. For example, lymphoma in the chest can lead to the swollen lymph node pressing on the windpipe (trachea) and may cause difficulty breathing, chest pain, or a chronic cough.

Non-Hodgkin Lymphoma Symptoms 

Non-Hodgkin lymphoma is a group of lymphomas, meaning there are multiple types of the condition. Most people with NHL have a type called B-cell lymphoma, which makes up 85% of all NHL cases. The other types include the T-cell type and NK-cell type. These lymphomas may not cause any signs or symptoms until cancer cells have begun to spread to other areas of the body.

Like Hodgkin lymphoma, the most common sign of NHL is a swollen lymph node in your neck, underarm, or groin. While less likely, it is still possible to have a swollen lymph node near your ears, elbow, or throat.

Non-Hodgkin lymphoma also causes B symptoms including night sweats, weight loss, and fatigue. B symptoms are important to monitor because they can help your healthcare provider determine the stage of cancer you are in.

Other general symptoms of B-cell NHL include:

• Frequent infections
• Easy bruising or bleeding
• Abdominal (stomach-related) swelling
• Feeling full after a small amount of food
• Shortness of breath 

Generally, NHL cancer cells begin to grow in the lymph nodes but could occasionally start in other areas of the body. These areas may include your bones, lungs, skin, or gastrointestinal tract (or, the passageway in your digestive system that runs from your mouth to your anus). 

Symptoms of other types of NHL may appear in your:

• Abdomen: Loss of appetite, nausea, vomiting
• Chest: Coughing and chest pain
• Brain: Headache, confusion, weakness, changes in personality, seizures
• Skin: Itching, redness, bumps right under the skin

Symptoms in Children

Lymphoma is more common in people as they age. The rates of Hodgkin lymphoma are highest among teenagers and young adults between the ages of 15 and 39 and older adults aged 75 and older.

While less common, children with lymphoma may be more likely to receive a diagnosis for childhood non-Hodgkin lymphoma. The three types of childhood NHL are:

• Aggressive mature B-cell non-Hodgkin lymphoma
• Lymphoblastic lymphoma
• Anaplastic large cell lymphoma

If your child does have childhood NHL, they may experience symptoms such as:

• Swollen lymph nodes
• Difficulty breathing
• Wheezing or coughing 
• Trouble swallowing food
• Fever with no other signs of infection or illness
• Unintentional weight loss
• Night sweats 
• Stomach pain or swelling

When to See a Healthcare Provider 

Many lymphoma symptoms can mimic symptoms of other less serious conditions. A variety of infections can cause swollen lymph nodes, so it can be difficult to determine when to call your healthcare provider. 

If you have noticed swollen lymph nodes or lumps under your skin with no other symptoms, it’s a good idea to make an appointment with your healthcare provider to understand why these lumps are occurring. It is especially important to talk with your provider if you have been experiencing the B symptoms of lymphoma:

• Fever without an infection
• Unintentional weight loss
• Fatigue 
• Night sweats that soak your pajamas or sheets

If your healthcare provider is concerned about lymphoma, they will refer you to a blood cancer specialist known as a hematologist-oncologist. This provider will conduct a physical exam, blood tests, and other diagnostic tests. 

Testing for cancer or receiving a lymphoma diagnosis can be scary—and it’s OK to feel afraid. But, it’s important to not let your fear prevent you from reaching out for medical support if you are not well. Getting an early diagnosis can help you improve symptoms and have better treatment outcomes as your condition progresses.