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Symptoms of non-Hodgkin's lymphomas
Last reviewed: 23.04.2024
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The anamnesis is not long, the symptoms of biological activity are noted in no more than 10-15% of patients. Symptoms of non-Hodgkin's lymphoma are mainly due to localization and mass of the tumor.
In children, 40-50% of non-Hodgkin's lymphomas are primarily localized in the abdominal cavity: in the ileocecal region, appendix, ascending colon, mesenteric and other groups of intra-abdominal lymph nodes. An increase in the abdomen with a general satisfactory state of the child may be the first symptom of the disease. With a physical examination, you can propalpate the tumor or identify ascites, hepatosplenomegaly. A frequent initial symptom-complex is a picture of an acute abdomen: pain, nausea and vomiting, symptoms of intestinal obstruction, acute appendicitis, gastrointestinal bleeding or intestinal perforation. Intraperitonealization is characteristic of the very rapidly growing Burkitt's lymphoma (and for berkittopodobnyh lymphomas), the progression of the disease occurs quickly, which necessitates prompt diagnosis and the urgent start of complex therapy.
Localization of the tumor in the mediastinum and thymus (20-25% of children's non-Hodgkin's lymphomas) leads to the development of symptoms of compression: an obsessive cough without signs of inflammation, difficulty breathing and swallowing, headaches, widening of the veins, edema of the neck and face. Often the presence of the tumor is combined with pleural effusion, which increases the symptoms of respiratory failure, effusion in the pericardium can lead to cardiac tamponade. There is a rapid development of bone marrow involvement with cytopenia, CNS involvement with convulsions, a violation of consciousness. Because of the rapid growth of the tumor (more often lymphoblastic T-cell), the listed symptoms quickly become life-threatening.
About 10-15% of non-Hodgkin's lymphomas in children are located in the area of the Valdeier ring, head and neck. The defeat of this area is characterized by the involvement of salivary glands, edema of the lower jaw, a unilateral increase in the pharyngeal tonsil with the corresponding symptoms, including the development of paresis of the cranial nerves in the onset of the disease.
Other primary localizations of non-Hodgkin's lymphomas: any groups of peripheral lymph nodes (characterized by asymmetric enlargement and compaction of nodes in the absence of signs of inflammation); kidney damage with the development of renal failure; defeat of bones, epidural space, orbit, skin (rarely).
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