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Symptoms of non-Hodgkin's lymphoma
Last reviewed: 06.07.2025
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The anamnesis is short-term, symptoms of biological activity are noted in no more than 10-15% of patients. Symptoms of non-Hodgkin's lymphoma are determined mainly by the 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 enlarged abdomen with a generally satisfactory condition of the child may be the first symptom of the disease. During physical examination, a tumor can be palpated or ascites, hepatosplenomegaly can be detected. 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. Intra-abdominal localization is characteristic of very rapidly growing Burkitt's lymphoma (and Burkitt-like lymphomas), the progression of the disease occurs quickly, which necessitates prompt diagnosis and urgent initiation of complex therapy.
Localization of the tumor in the mediastinum and thymus (20-25% of childhood non-Hodgkin's lymphomas) leads to the development of compression symptoms: obsessive cough without signs of inflammation, difficulty breathing and swallowing, headaches, varicose veins, swelling 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. Bone marrow damage with cytopenia, CNS damage with seizures, impaired consciousness develop quickly. Due to the rapid growth of the tumor (usually lymphoblastic T-cell), the listed symptoms quickly become life-threatening.
About 10-15% of non-Hodgkin's lymphomas in children are localized in the Waldeyer's ring, head and neck. The lesion of this area is characterized by the involvement of the salivary glands, swelling of the lower jaw, unilateral enlargement of the pharyngeal tonsil with corresponding symptoms, including the development of cranial nerve paresis at 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 the nodes in the absence of signs of inflammation); kidney damage with the development of renal failure; damage to bones, epidural space, orbit, skin (rare).
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