Clinical Presentation
Signs/Symptoms
Assess the patient’s performance status based on the clinical
presentation.
The systemic B-cell symptoms are:
- Usually present in aggressive types of non-Hodgkin’s lymphomas
- Fever
- Night sweats
- Weight loss
Most
types of non-Hodgkin’s lymphoma have:
- Splenomegaly
- Hepatomegaly
- Lymphadenopathy
- Cytopenia
The
nonspecific signs and symptoms are:
- Skin rash
- Generalized fatigue
- Fever
- Pleural effusion
- Pruritus
- Malaise
- Ascites
Lymphoma
with gastrointestinal (GI) tract involvement may have:
- Anorexia
- Weight loss
- Bloatedness
- Pallor
- Nausea/vomiting
- Abdominal pain
- Early satiety
- Intestinal bleeding
Lymphoma
with central nervous system (CNS) involvement may have:
- Headache
- Blurred vision
- Paralysis
- Dizziness
- Seizures
- Focal neurologic symptoms
Adult
T-cell leukemia/lymphoma may have:
- Lymphadenopathy
- Fatigue
- Anorexia
- Splenomegaly
- CNS involvement
- Pulmonary complications
- Skin eruptions
- Abdominal pain
- Hepatomegaly
- Bone marrow involvement
Burkitt
lymphoma may have:
- Bone marrow (70%) involvement
- Leptomeningeal CNS involvement (40%)
Extranodal
NK/T-cell lymphomas (ENKL), nasal type, may have:
- Nasal obstruction
- Nasal bleeding secondary to mass lesion
- Elevated lactate dehydrogenase (LDH) levels
Non-Hodgkins Lymphoma_Initial AssesmentPhysical Examination
During physical examination:
- Assess node-bearing areas
- Assess for spleen, liver enlargement, especially in FL, hairy cell leukemia (HCL), Mycosis fungoides (MF)/Sézary syndrome (SS), BL, diffuse large B-cell lymphoma (DLBCL), MCL
- Examine the testicles as suggested in ENKL
- Skin examination: Inclusion of Waldeyer’s ring in ENKL and identification of type of skin lesion in patients with SS