Lymphoma symptoms

Symptoms

At the Hodgkin lymphoma In the vast majority of cases (70%) there is initially a rubber-like, palpable enlargement of one Lymph node, which in most cases is on neck is localized. The Swelling of the neck is painless. Lymph nodes above the collarbone, in the armpit or in the groin are rather rare.

In a third of patients with lymphoma, the first symptom is swelling of the lymph nodes behind the breastbone. As a rule, this cannot be felt, but it becomes noticeable by a chronic dry cough that is triggered by it.
Furthermore, breathing can be hindered and a feeling of pressure can be triggered.
In addition, individual lymph nodes distributed throughout the body can be affected and swell, leading to Pain, Feelings of pressure and Diarrhea can lead.

Seldom but characteristic of Hodgkin's lymphoma is tenderness in the affected lymph nodes Alcohol consumption.
Some of the patients also complain about fatigue, Performance kink, itching all over the body as well as over the so-called B symptoms.

This includes night sweats, weight loss of more than 10% of the total weight in the last six months and a fever of over 38 degrees Celsius. Furthermore, the patients often complain of increased infections, such as colds, flu infections, skin rashes, Fungal infection etc. which result in a weakening of the immune system by this disease. If the skeletal system is already affected, bone pain can occur if the liver is affected, there is usually a painful swelling.

In non-Hodgkin's lymphoma, too, lymph node swelling caused by degenerate lymphocytes as well as fatigue and poor performance occur in the patients. In contrast to Hodgkin's lymphoma, the so-called B symptoms occur relatively rarely with only 20%. In contrast, the pain in the bone system is more common than with Hodgkin's lymphoma. Furthermore, the skin can also be involved in non-Hodgkin's lymphoma, and the liver and spleen are affected much more frequently than in Hodgkin's lymphoma. 1/4 of the patients with chronic lymphocytic leukemia tend to have no symptoms at the beginning of the disease.

Read more on the topic: Non-Hodgkin lymphoma

The most common symptom is painless swelling of the lymph nodes in the neck, in the armpit (lymph node swelling in the armpit) and in the groin region and on the collarbone. Lymph nodes can also be distributed individually in the body, which can lead to corresponding symptoms. The liver is involved in 15% of the cases and the spleen is involved in 50%. Night sweats, fever and weight loss are usually only complained by patients after the disease has progressed. It can also lead to an increased susceptibility to infections due to the weakened immune system.

You can also find more information here: Symptoms of lymph gland cancer

Course of the disease

The course of a Lymphoma disease is difficult to predict.

Especially under the term of Non-Hodgkin lymphoma (Abbreviation NHL) various diseases are summarized, which are based on the degeneration of lymphocytes as the cause of the disease, but which can differ in their ultimate course.
A settlement of the degenerate cells in the lymphatic system is typical. These cells are also found there in healthy people, but in significantly lower numbers. Their real job is the immune defense.
With some forms of the Non-Hodgkin lymphoma the degenerated lymphocytes initially only spread in the lymphatic system. This then results, for example Enlargement of the lymph nodes in different areas of the body or swelling of the spleen or the tonsils, which are also part of the lymphatic system.

Especially in advanced stages of the disease, degenerate lymphocytes can spread from the lymphatic system via the blood into various organs, such as liver, lung and skeleton come.
This disease progression is worse forecast afflicted. Depending on how quickly the disease progresses, i.e. at what time interval it increases Lymph node swelling, Organ involvement and other symptoms such as fever, Night sweats and Weight loss occur, a distinction is made between highly malignant, very aggressive and low-grade, less aggressive forms of lymphoma.
The highly malignant forms end more quickly if there is no therapy, some even fatally within a few months, while low-malignant forms can persist, sometimes for years, without any significant worsening of symptoms.

In addition, an earlier organ involvement can often be observed in highly malignant forms. Since in the highly malignant form the degenerated lymphoma cells divide accordingly frequently and at short intervals, this often speaks better to one chemotherapeutic treatment on.
The reason for this is that these drugs mainly destroy cells that divide rapidly. It is important to note that the individual courses can differ significantly from individual to individual, even if they are suffering from the same form of lymphoma.

A person of older age with many other pre-existing conditions, such as heart disease or immune deficiency, has a different prognosis from the outset in terms of life expectancy and the further course of the disease than a young, otherwise healthy person.

Symptoms on the lungs

Tumor growths can also develop in the lungs as part of the lymphoma disease.

If it is not yet known that the person affected has lymphoma, this can be done at the beginning Lung cancer be confused. If the organ is now also affected as part of the lymphoma, this can be an indication that the disease has already progressed further.
Those affected with lung involvement suffer on the one hand from general symptoms that are typically associated with the disease, such as enlarged, non-tenderness Lymph nodes in different parts of the body as well as under tiredness and poor performance.

In addition, occur frequently feverwhich can hardly be lowered night sweats and an unwanted weight loss of over 10 percent of the initial body weight. If lymphomas are now located in the area of ​​the lungs, the trachea and / or the bronchi, they can compress the lungs and airways, especially due to constant growth, and accordingly cause problems with inhalation or exhalation itself, shortness of breath and, above all, with irritation of the Trachea to persistent to cough to lead.
These problems can exacerbate the already existing symptoms, such as fatigue. The tumors often provoke the development of pulmonary effusions.
This is understood to mean accumulations of fluid between the pleural leaves, which surround the lungs like a sack and make an important contribution to functioning breathing. This becomes noticeable in the affected person in the form of difficult breathing and shortness of breath.

Symptoms on the neck

The main symptom of a lymphoma disease is not painful Enlargement of the lymph nodes on different regions of the body. Especially with Hodgkin lymphoma these swellings can be found, often on one side, in the neck area. (see also: Lymph node swelling in the neck) This is where the majority of the body's lymph nodes are located, even in healthy people.
The degenerate lymphocytes settle in these lymph nodes and, due to their unhindered growth, lead to the enlargement of the affected lymph nodes.

When the diagnosis is made, many of those affected already have significantly enlarged lymph nodes. In addition to their size and painlessness, these are noticeable because they cannot be moved in their surroundings. Individual lymph nodes are often glued together, which is known as baked. The enlargements on the neck cause the person concerned few complaints, mainly due to their painlessness, which is why a doctor is often only seen late.

Changes in blood count

The Examination of the blood is essential for the diagnosis and follow-up of a lymphoma.

In addition to the current state of health of the person concerned, parts of various organ functions can be examined in this way and assessed over the course of the process.
This is of great importance because certain lymphomas are able to colonize and damage organs in addition to the lymphatic system. At the beginning of the lymphoma disease, the blood count is normal in the majority of those affected.
In the course of time, however, many become numerical Decrease in red blood cells (Erythrocytes), of the Platelets (Platelets) and the white blood cells (Leukocytes).

The precursor cells of these blood components are located in the Bone marrowThis also applies to those of the lymphocytes, which lead to the clinical picture of lymphoma when they degenerate. These cells are part of the immune system and can also be found in the bone marrow and blood of healthy people.

In people with lymphoma, however, as mentioned, lymphocytes are degenerate, so that they can multiply unhindered in the bone marrow and displace the precursor cells of the other blood components over time.
This explains the numerical changes already described in the blood count of those affected. A deficiency in red blood cells is known as anemia. This is expressed, among other things, by Exhaustion, easy fatigue, Pale skin and shortness of breath even with a low level of stress.
A lack of blood platelets is known as Thrombocytopenia. It manifests itself in small hemorrhages, especially in the area of ​​the legs and the oral mucosa. The punctiform hemorrhages are called Petechiae designated.

A deficiency in white blood cells manifests itself in an increased susceptibility to infections. Another way of testing the blood to confirm the diagnosis of lymphoma and to determine the exact type of lymphoma is to stain the lymphocytes with certain dyes. In these immunohistochemical examinations, certain surface areas of the lymphocytes are coupled to dyes and the different types are differentiated on the basis of the different colors.

More information can be found here: Diagnosis of lymph gland cancer

Symptoms in Children

Lymphomas are the third most common cancer in children in Germany.

Overall, they account for ~ 12% of all childhood and adolescent cancer. Even with children Hodgkin- from Non-Hodgkin-Lymphoma differentiated. The two forms of the disease are often not clearly distinguishable simply by the symptoms. A classification is often only made after the histological-microscopic examination of the affected tissue, usually lymph nodes.

When Hodgkin lymphoma are so-called B lymphocytes degenerated into cancer cells. In healthy people, these lymphocytes convert to plasma cells after activation, which ultimately produce antibodies for the immune system. Older children in particular develop this form of lymphoma, while toddlers under 3 years of age are almost never affected.
However, the main incidence peak is in adulthood. It is not yet clear why the cells degenerate.
In the course of various examinations and studies it has been observed that especially people with innate or acquired immunodeficiency and / or those on Pfeiffer's glandular fever (Epstein-Barr virus pathogen) sufferers are more likely to develop a lymphoma than those who were previously completely healthy.
The cancer makes its way through various Swelling of the lymph nodes, but especially in the area of ​​the neck and neck (please refer: Lymph node swelling in the neck) noticeable. These swellings are palpable and not painful.

In the course of the disease, persistent fever, night sweats and a high, unwanted weight loss on. The children complain of tiredness, weakness and of quickly getting out of breath with even the smallest effort. Some affected children also suffer from itching the whole body. If the degenerated cells have settled in the area of ​​organs such as the lungs or in the abdomen, the growth in the former can lead to breathing problems and coughing, and the latter can lead to visible swellings on the abdomen, but also digestive problems, such as diarrhea or constipation come.
Since the spleen is one of the lymphatic organs in which the degenerate lymphoma cells prefer to reside and settle, the organ also swells over the course of the process. The spleen is unnaturally palpable below the left costal arch.
In healthy people, the spleen cannot be palpated. As the blood backs up into the liver due to this swelling, it too becomes enlarged after a while. When the bone marrow is infiltrated, children often complain of bone pain.

By suppressing the rest of the blood formation, among other things, there is a shortage of red blood cells, which is known as anemia and is the reason for tiredness and the decline in performance in children.
As a result, the skin appears pale. Symptoms typically do not appear suddenly, but gradually appear over a period of weeks to months.

Therapy is planned on site after the diagnosis, which is usually carried out in a specialist hospital. Current symptoms as well as the condition of the sick child as well as the current tumor stage and the lymphoma sub-form are taken into account in the planning. Non-Hodgkin lymphomas are caused by the degeneration of B or T lymphocytes.
These cells form part of the immune system in healthy people. B-cell lymphomas are proportionally much more common than T-cell lymphomas. As in Hodgkin's lymphoma, the degenerate cells preferentially settle in the lymph nodes, which consequently swell and sometimes increase in size. Non-Hodgkin lymphoma (NHL) that occur in children are often very aggressive, that is, to a high degree malignant (vicious).
If left untreated, the disease would quickly lead to death. The symptoms of non-Hodgkin lymphoma are similar to those described for Hodgkin lymphoma. However, the course of symptoms is often faster than in Hodgkin's lymphoma due to the mostly aggressive growth of NHL cancer cells. In addition, existing symptoms deteriorate more quickly. A very rapid increase in tumor-related swellings in various parts of the body is also frequently observed.

Common to both diseases is the typical, painless enlargement of lymph nodes in different parts of the body. In the case of non-Hodgkin lymphoma, in addition to the organ-related symptoms that also occur in Hodgkin lymphoma, the meninges can be “colonized” by the malignant lymphoma cells. The affected children complain of severe headaches. As the disease progresses, the pressure in the brain can increase, which is noticeable, among other things, by vomiting on an empty stomach and visual disturbances. A final differentiation between Hodgkin's and non-Hodgkin's lymphoma is only possible with a histological microscopic examination of the affected tissue, despite the more rapid symptomatic course of the NHL.