What are the symptoms of mid- to late-stage lymphoma?

Due to the different sites and ranges of lesions, the symptoms of lymphoma in the middle and late stages are varied. Primary lesions can be seen in lymph nodes, and can also be seen in organs other than lymph nodes, such as tonsils, nasopharynx, gastrointestinal tract, spleen, bones and skin. Extranodal lesions are more common than non-Hodgkin lymphoma. The disease spreads from the primary site and adjacent lymph nodes in sequence, such as Hodgkin's disease, and also spreads to distant lymph nodes across the adjacent lymph nodes, which is common in non-Hodgkin's lymphoma. Non-Hodgkin's lymphoma can also originate from multiple centers, so the disease often spreads throughout the body in the early stages. Lymphoma can have only a single group of lymph node enlargement without systemic symptoms, or there can be systemic infiltration without superficial lymph node enlargement, accompanied by corresponding symptoms and signs. Hodgkin's disease often has superficial lymph node enlargement as the first symptom, and only 9% of cases are primary in tissues and organs other than lymph nodes, while non-Hodgkin's lymphoma is more common in cases where the primary is outside the lymph nodes, and many cases are transformed into leukemia.

The systemic symptoms of malignant lymphoma vary greatly depending on the type of disease and the stage in which it occurs. Some patients may have no systemic symptoms. Fever, weight loss (weight loss of more than 10%), night sweats, etc. are more common in patients with symptoms, followed by loss of appetite, fatigue, itching, etc. Systemic symptoms are related to the age of onset, tumor range, and body immunity. Elderly patients, those with poor immune function or multifocal onset have significant systemic symptoms. The survival rate of patients without systemic symptoms is 3 times that of those with symptoms.

1. Fever:

The fever pattern is often irregular, and can be continuous high fever, or intermittent low fever. A few have periodic fever, the latter of which is seen in about 1/6 of Hodgkin's disease patients. Early fever accounts for about 30% to 50% of Hodgkin's disease, but non-Hodgkin's disease usually only causes fever when the lesions are more extensive. Profuse sweating when the fever subsides can be a characteristic of this disease.

2. Skin itching:

This is a more specific manifestation of Hodgkin's disease. Focal pruritus occurs in the area of ​​lymphatic drainage of the lesion, and generalized pruritus mostly occurs in cases with lesions in the mediastinum or abdomen.

3. Alcohol pain:

About 17% to 20% of Hodgkin's disease patients experience pain in the lesion 20 minutes after drinking. This symptom may occur earlier than other symptoms and X-ray manifestations, and has a certain diagnostic significance. When the lesion is relieved, the alcohol pain disappears immediately, and it worsens when it recurs.

4. Symptoms of extranodal lesions:

1) Gastrointestinal tract: Lymphoma lesions in extranodal lymphoid tissue are most common in the gastrointestinal tract, accounting for 13% to 25% of non-Hodgkin's lymphoma and only 2% of Hodgkin's disease. Clinical manifestations include loss of appetite, abdominal pain, diarrhea, abdominal distension, intestinal obstruction and bleeding. The most common site of invasion is the small intestine, of which more than half are the ileum, followed by the stomach. The colon is rarely affected. Primary small intestinal tumors are most common in non-Hodgkin's lymphoma, with malabsorption syndrome or steatorrhea as the main clinical manifestations, and lesions often occur in the jejunum. Gastrointestinal lesions generally spread from the retroperitoneal lymph nodes through the mesenteric lymphatic vessels.

2) Hepatobiliary: Invasion of the liver parenchyma may cause pain in the liver area. Jaundice may occur when diffuse infiltration or enlarged lymph nodes in the liver are detected by the common bile duct. About 15% of patients with Hodgkin's disease involving the liver have jaundice.

3) Skeleton: Clinical manifestations include local bone pain and secondary nerve compression detection symptoms.

4) Skin: Nonspecific lesions commonly include pruritus and prurigo. Pruritus is more common in Hodgkin's disease (accounting for 85%) and may appear before other rashes. Severe sweat retention can also be seen occasionally.

5) Tonsillar and oral, nasal, and pharyngeal lymphomas that invade the oral and nasopharyngeal regions may present clinical symptoms such as dysphagia, nasal congestion, and epistaxis.

6) Others: Lymphoma can also infiltrate the pancreas and cause malabsorption syndrome. Mediastinal lymphoma can metastasize to the pericardium and cause local tumors. Infiltration of the breast, thyroid, lacrimal gland, bladder, testicles, and ovaries, which can cause corresponding symptoms, is very rare.

The above is a brief introduction to lymphoma. For people who are related to the pathogenic factors of lymphoma, it is recommended to take preventive measures for lymphoma and receive specific treatment according to the doctor's instructions. I hope that patients can recover soon! If you have other questions about lymphoma, please consult our experts online or call for consultation.

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