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Symptoms of Non-Hodgkin’s lymphoma

Presenting clinical features/ what brings the patient to the doctor. The majority of patients present with an enlargement of lymph node groups, for example the enlargement of nodes in the neck. Such presentations are usually as the painless development of the lumps, which the patient soon realises are abnormal.


In low grade NHL the development of these nodal lumps is slow and insidious but in high grade tumours the growth may be fast and very worrying to the patient. Occasionally, the lymph nodes develop deep inside the patient; for example, a lymph node mass in the chest may remain silent (i.e. un-noticed by the patient) until it presses on the wind-pipe and then the patient comes urgently to the doctor because he has difficulty in breathing.


Sometimes, the nodal mass may be in the abdomen and disturbance of bowel function may cause the presenting symptom.


 Sometimes the NHL occurs outside the lymph nodes and the thyroid has already been cited above and is a good example. Others include primary stomach NHL, conjunctival or even intra-ocular NHL and primary brain NHL is a rare form (although commoner in kidney transplant recipients). In the preceding section, there is a photo of a lymphoma arising on the skin of the eyelid.


In patients with a large bulk of lymphoma in their bodies, there may be significant weight loss or sweating (the so-called 'B' symptoms).

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