clinical manifestations of non-Hodgkinlymphoma

Since NHL is a general term for a group of malignant tumors of the lymphoid hematopoietic system, the clinical manifestations have certain common characteristics, and at the same time, there are great differences according to different pathological types, sites and extents of the invasion. Although the disease occurs in the lymph nodes, according to the distribution characteristics of the lymphatic system, NHL is basically a systemic disease.

1. Partial performance

(1) Lymph node enlargement is the most common and classic clinical manifestation. It is characterized by painlessness and gradual enlargement. Part of the lymph nodes will have local compression symptoms when they rapidly enlarge, accompanied by swelling and pain. Swollen superficial lymph nodes are more common in the neck, supraclavicular, and underarm areas. Deep lymph node enlargement is more common in the mediastinum, retroperitoneum, and mesenteric area. The site of the affected lymph node is often hopping, with no regularity.

(2) Extra-lymphatic organs are mainly gastrointestinal tract, skin, bone marrow, central nervous system and other parts. The thyroid, bones, reproductive system, and nasal cavity are also vulnerable organs. Invasion of extra-lymph node organs can co-exist with lymph nodes, or it can exist alone. The clinical manifestations are complex and diverse.

(3) Most of the lymphomas of the nasal cavity with nasal cavity lesions are NHL. The main pathological types are nasal NK/T cell lymphoma and diffuse large B cell lymphoma in NHL. Early lesions are mostly limited to the inferior turbinate of one side of the nasal cavity, manifesting as nasal congestion, epistaxis, and local mucosal ulcers. As the disease progresses, it can invade the contralateral nasal cavity or adjacent tissues and organs, manifesting as tinnitus, hearing loss, sore throat, hoarseness, and swelling of the cheek. Tumor invasion can destroy bone and cause corresponding symptoms such as nasal septum and hard palate perforation.

2. Whole body performance

Different systemic symptoms can occur before or at the same time as the lymph nodes are enlarged.

(1) Fever Most NHL patients have fever, but the duration of fever, the height of temperature, and the periodic changes of fever can be different. The duration of fever in some patients can be calculated in months, and the pathological evidence of the relevant parts is ultimately required to be diagnosed.

(2) Night sweats and weight loss Due to the failure of the body's immune function and the progression of tumor diseases, or accompanied by wasting factors such as fever, patients often experience hyperhidrosis, night sweats at night, and progressive weight loss.

(3) Skin itching and skin lesions NHL can have a series of non-specific skin manifestations. The tumor can be primary in the skin or secondary skin invasion, with an incidence of 13% to 53%. Some skin itching can occur before the diagnosis is made. Common skin manifestations are pellagra-like papules, herpes zoster, generalized herpes-like dermatitis, skin pigmentation changes, and erythema nodules. The skin damage is pleomorphic, such as plaques, blisters, erosions, nodules, etc. Part of the skin damage can be ulcerated and exuded for a long time. Due to tumor invasion and reduced immune function, it is easy to be infected with long-term non-healing, which is also one of the reasons for fever in NHL patients.

(4) Abdominal manifestations: Mesenteric and retroperitoneal lymph nodes are the most common lesion sites, and the gastrointestinal tract is the most common extranodal lesion site. According to the affected part, it often manifests as a feeling of fullness in the abdomen, abdominal pain, indigestion, abdominal mass, gastrointestinal bleeding, etc., and it is prone to acute abdominal symptoms such as intestinal obstruction and intestinal perforation. Hepatosplenomegaly is not uncommon in NHL patients, most of which are caused by liver and spleen invasion.