These symptoms may be a sign of lymphoma

This is the 5297th article of Da Yi Xiao Hu

Lymphoma is a malignant tumor originating from the lymphatic system. Its early symptoms are very atypical and easily confused with other diseases. Therefore, understanding these symptoms and adopting effective screening strategies are of vital importance for early detection of lymphoma, improving treatment outcomes, and prolonging survival.

1. Swollen lymph nodes

Swollen lymph nodes are the most common and most intuitive symptom. These lumps are usually painless, hard, and movable, and are commonly found in the neck, armpits, groin, etc. It is worth noting that swollen lymph nodes are not an exclusive symptom of lymphoma, but may also be caused by infection, inflammation, etc., so it is necessary to make a comprehensive judgment in combination with other symptoms.

1. Lymph node palpation and associated symptoms

Lymph node enlargement caused by lymphoma is often painless, hard, and poorly mobile. It may continue to grow, and multiple lymph nodes may be affected at the same time, commonly in the armpits and groin. Lymph nodes can also adhere to each other and fuse into clumps. It is accompanied by systemic symptoms such as fever, night sweats, weight loss, fatigue, and itching. Some patients may also experience compression symptoms such as difficulty breathing and swallowing.

Lymph node enlargement caused by inflammation is usually accompanied by pain or tenderness, soft texture, good mobility, accompanied by local symptoms such as redness, swelling, and fever, as well as systemic symptoms such as fever and fatigue (but usually not as severe as lymphoma).

2. Lymph node aspect ratio

The aspect ratio of lymph nodes is an important parameter for evaluating the pathological characteristics of lymph nodes by measuring the ratio of the long and short axes of lymph nodes through ultrasound imaging. The long axis refers to the longest diameter of the lymph node, usually measured along the length of the lymph node; the short axis refers to the short diameter of the lymph node, usually measured perpendicular to the long axis. The aspect ratio is the value of the short axis divided by the long axis.

The aspect ratio of lymph node enlargement caused by lymphoma may be higher. This is because lymphoma cells grow and multiply in the lymphatic system, which may cause damage to the internal structure of the lymph nodes, causing the lymph nodes to expand in the short axis direction and grow relatively slowly in the long axis direction, resulting in an increase in the aspect ratio. It should be noted that the aspect ratio of lymph nodes may vary among different lymphoma patients, and this parameter is not a specific diagnostic indicator for lymphoma. Benign lymph nodes, such as those caused by infection, inflammation, etc., usually maintain this normal aspect ratio. After anti-inflammatory treatment, the lymph nodes usually gradually shrink and return to normal.

2. Fever

The immune system of lymphoma patients is invaded by tumor cells, resulting in abnormal function of the body temperature regulation center. Lymphoma cells themselves may release pyrogenic factors, causing fever. In addition, lymphoma patients may have a large tumor load, which increases body metabolism and generates excessive heat, thus causing fever.

Inflammatory fever is an inflammatory response caused by infection, trauma and other factors, which causes white blood cells to release cytokines, such as interleukin and tumor necrosis factor, which act on the body temperature regulation center to cause fever. Inflammatory fever is usually accompanied by local or systemic inflammatory reactions, such as redness, swelling, heat and pain.

3. Night sweats

The most common time for lymphoma night sweats is during sleep at night. The main feature is the secretion of a large amount of sweat. This sweat is richer than normal sweat and can completely soak clothes or sheets. Unlike sweat secretion during exercise, lymphoma night sweats cannot be controlled or prevented. Persistent night sweats: Night sweats last for a long time, usually for weeks or months. This damp and cold sweat secretion cannot be relieved by adjusting the room temperature or keeping the body cool.

4. Itching

The itching caused by lymphoma is usually widespread and can occur in various parts of the body, but it is particularly common in the lower limbs and trunk. The itching is quite severe and often unbearable. The itching caused by lymphoma is usually long-term and will not be relieved by simple skin care. Even with conventional antipruritic treatments, it is not easy to relieve. The itching symptoms may exist for a long time and often recur. This itching often worsens at night and affects sleep. The itching caused by lymphoma usually has no clear external triggers, such as allergies or contact with certain substances, and is not easily relieved by conventional anti-allergic drugs. In most cases, the itching caused by lymphoma is not accompanied by obvious rashes or other visible skin changes, but repeated scratching may lead to skin damage and secondary infection.

V. Others

Lymphoma may also compress surrounding tissues or organs, causing symptoms such as difficulty breathing, difficulty swallowing, abdominal pain, back pain, and digestive system symptoms such as loss of appetite, nausea, vomiting, diarrhea, or constipation.

6. Lymphoma Screening

The onset of lymphoma is related to many factors, including genetics, environment, and lifestyle. Therefore, identifying high-risk groups and adopting targeted screening strategies are important for early detection of lymphoma. People who have long-term exposure to radiation, chemicals (such as pesticides, hair dyes, etc.), suffer from immune system diseases (such as rheumatoid arthritis, systemic lupus erythematosus, etc.), genetic factors (such as a family history of lymphoma), or are elderly and frail are all high-risk groups for lymphoma.

In order to detect lymphoma early, high-risk groups should be screened regularly. Screening techniques include routine blood tests and biochemical tests, immunoglobulin tests, bone marrow biopsy, and imaging tests. Routine blood tests and biochemical tests can reflect the patient's physical condition and immune function status, and help to detect early signs of lymphoma. Immunoglobulin tests can evaluate the patient's immune function and are of auxiliary significance for the diagnosis of lymphoma. Bone marrow biopsy is one of the important means of diagnosing lymphoma, and can directly observe whether there is abnormal lymphocyte infiltration in the bone marrow. Imaging examinations, such as B-ultrasound, CT, MRI, etc., can show the distribution and size of lymphoma in the body, providing an important basis for diagnosis and treatment.

For high-risk groups, regular screening is the key to preventing lymphoma. It is recommended to have a comprehensive physical examination at least once a year, including blood routine, biochemical tests, immunoglobulin tests, and imaging tests. At the same time, pay close attention to your physical condition. Once the above symptoms occur, you should immediately seek medical attention for further examination.

Author: Hematology Hospital, Chinese Academy of Medical Sciences

Wang Hailong