Testing for lymphoma involves a doctor's physical exam, blood tests, and imaging (CT, PET, MRI) to look for signs, but a lymph node biopsy is essential for a definitive diagnosis, often requiring removal of a whole node (excision biopsy) for accurate analysis under a microscope, with bone marrow biopsy and spinal tap used for staging if needed.
Because infections are the most common cause of enlarged lymph nodes, the doctor will look for an infection near the swollen lymph nodes. The doctor also might order blood tests to look for signs of infection or other problems. Blood tests aren't used to diagnose lymphoma, though.
Warning signs of lymphoma often include painless swelling of lymph nodes (neck, armpit, groin), persistent fatigue, unexplained fever, and drenching night sweats, alongside weight loss, persistent itching, cough, or shortness of breath. Other signs can involve easy bruising, frequent infections, or abdominal pain/swelling, but these symptoms can also signal other conditions, so seeing a doctor for a proper diagnosis is crucial.
How is Lymphoma Diagnosed? Your doctor may order a blood test if they notice enlarged lymph nodes during a physical exam, along with other signs or possible symptoms of lymphoma. However, a blood test alone cannot diagnose lymphoma in most cases. A biopsy is the only way to definitively diagnose lymphoma.
Common symptoms of having lymphoma include swelling of lymph nodes in your neck, in your armpits or your groin. This is often but not always painless and often could be associated with fevers, or unexplained weight loss, or drenching night sweats, sometimes chills, persistent fatigue.
Some infections can cause symptoms similar to lymphoma:
The most common symptom of lymphoma is a painless swelling or lump in the neck, armpit or groin. This is caused by lymphoma cells building up in the lymph nodes, which makes them bigger.
NHL usually starts in lymph nodes or other lymph tissue, but it can sometimes affect the skin.
Hodgkin Lymphoma Risk Factors
An ultrasound scan (sometimes called a sonogram) uses soundwaves to take pictures inside your body. You might have an ultrasound scan if you have lymphoma, or your doctor suspects you could have lymphoma. This could be to: examine lymph nodes that are near the surface of your skin.
Although both diseases can be diagnosed at any age, Hodgkin lymphoma is most common in young adults ages 15 to 40 and older adults over age 55. Non-Hodgkin lymphoma is typically diagnosed in adults over age 60. Some viruses may make you more likely to get both Hodgkin and non-Hodgkin lymphoma.
Cancer-related fatigue is exhaustion that's at a much higher level than would usually be expected. It can be physical, emotional or mental. You might feel very tired after doing quite little. Fatigue can affect different areas of your life.
From the available research, there isn't strong evidence that stress can cause or worsen lymphoma or any type of cancer, or that it can make it come back (relapse).
However, cancer-related lymph node swelling typically feels firm and painless, persists beyond 2 weeks, and may appear in multiple locations. Unlike infection-related swelling that feels tender and warm, cancerous nodes remain painless and continue growing over time.
NHL is a disease that usually comes on suddenly and gets worse quickly. Symptoms vary depending on where tumor(s) are. These are the most common locations and their symptoms: Abdomen – pain, swelling, fever, anemia, tiredness, weight loss, vomiting, diarrhea, constipation, and irregular periods.
Lymphoma's exact cause is often unknown, but it develops from genetic damage to lymphocytes (white blood cells), leading to uncontrolled growth, with risk factors including a weakened immune system (from diseases or medications), certain viral/bacterial infections (like Epstein-Barr, HIV, H. pylori), family history, exposure to specific chemicals (benzene, pesticides), radiation, and lifestyle factors like smoking, notes Cancer Council.
Hodgkin lymphoma starts in the lymph nodes of the neck and spreads in an orderly fashion from the neck area down to the rest of the body. Signs of lymphoma can include: Enlarged lymph node in the neck, shoulder or chest (most common symptom)
Some people experience lower back pain that is unexplained. It is thought that this may be caused by expanding lymph nodes pressing on nerves.
Indolent lymphoma, also known as low-grade lymphoma, is a group of slow-growing non-Hodgkin lymphomas (NHLs). Because they spread slowly, they tend to have fewer signs and symptoms when first diagnosed and may not require immediate treatment.
High White Blood Cell Count
Certain types of cancer, including lymphoma, may lead to an abnormally high WBC count. A high WBC count, also known as leukocytosis, can also indicate an infection or dysfunction in the immune system. If the lymphocyte count is high, it's known as lymphocytic leukocytosis.
With lymphoma, you can itch anywhere on your body, but it's common on the lower legs, hands, feet, torso (between waist and shoulders), or near affected lymph nodes, often worsening at night and without a typical rash, feeling deep and unrelieved by scratching. This itchiness is caused by immune chemicals (cytokines) irritating nerve endings, and can be a symptom of both Hodgkin and non-Hodgkin lymphoma.
Overall, the average age at diagnosis is 39. Hodgkin lymphoma is rare in children younger than 5 years old, but it's the most common cancer diagnosed in adolescents ages 15 to 19 years. For statistics related to survival, see Survival Rates for Hodgkin Lymphoma by Stage.
While Hodgkin Lymphoma (HL) often has better overall survival rates (around 90% 5-year survival vs. NHL's ~74%) and a more predictable spread, making it highly treatable, Non-Hodgkin Lymphoma (NHL) is more common, has many aggressive subtypes, and can be harder to cure, though many slow-growing NHLs behave like chronic conditions. The "worse" type depends on the specific subtype, stage, and individual factors, as NHL encompasses over 60 types, some very aggressive and others very slow-growing.
Key takeaways: Night sweats, persistent fevers and unexplained weight loss are three of the most common lymphoma symptoms. Symptoms can appear with any type of lymphoma, but they're more commonly seen in advanced, fast-growing blood cancers.
Lymphomas are perhaps the cancer type that is most closely associated with oncogenic viruses: infection with EBV, human T-lymphotropic virus 1 (HTLV-1), human immunodeficiency virus (HIV), Kaposi sarcoma-associated herpesvirus/human herpesvirus 8, and hepatitis C virus have all been associated with lymphomagenesis.