Cancer involves abnormal cells growing uncontrollably, invading nearby tissues, and spreading to other parts of the body through metastasis.
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The main sign of lymphoma is swollen lymph nodes, called lymphadenopathy. In cancer, this swelling is usually painless. People often find these lumps by accident when bathing or getting dressed. The most common places to notice them are the neck, just above the collarbone, the armpits, and the groin.
Lymph nodes swollen from infection are usually soft, tender, and move easily. In lymphoma, the nodes often feel firm or rubbery and may not move. They can get bigger over weeks or months and sometimes join together into large lumps, called “bulky disease.” Lymphoma can also cause swelling in deep nodes inside the chest or abdomen that you cannot feel from the outside.
Where the swollen nodes are can cause other symptoms by pressing on nearby body parts. For example, large nodes in the chest can press on the windpipe, leading to a dry cough, trouble breathing, or a heavy feeling in the chest. If they press on the main vein returning blood from the head, it can cause swelling of the face and neck, which is a medical emergency and needs quick treatment.
A group of symptoms called “B Symptoms” is important for staging lymphoma. These include signs that the whole body is reacting to the cancer, like inflammation and high energy use by the tumor. Having B symptoms usually means the disease is more advanced or aggressive and can affect how doctors choose treatment.
The first B symptom is fever. This is usually a fever that keeps coming back or does not go away, with a temperature over 38°C (100.4°F). In Hodgkin Lymphoma, there is a rare pattern called Pel-Ebstein fever, where high fevers come and go over days or weeks. This fever is not caused by infection but by chemicals released by the tumor.
The second B symptom is heavy night sweats. These are not just mild sweating—they are so severe that clothes and sheets get soaked, sometimes needing to be changed during the night. This happens because chemicals from the lymphoma reset the body’s temperature control. The third B symptom is unplanned weight loss, meaning losing more than 10% of body weight in six months without trying. This happens because the tumor uses up the body’s energy and reduces appetite.
Although lymphoma starts in the lymph nodes, lymphocytes travel throughout the body, so the disease can appear in almost any organ. This is called extranodal disease. For example, lymphoma in the stomach (often MALT lymphoma) can cause symptoms like an ulcer or gastritis, such as stomach pain, nausea, and feeling full quickly. Skin lymphoma (Cutaneous T Cell Lymphoma) can show up as itchy red patches, bumps, or tumors, and is often mistaken for eczema or psoriasis for a long time.
A particularly distressing symptom associated with Hodgkin Lymphoma is pruritus, or severe itching. This itching can be generalized or localized. It is often intense and burning, yet there is usually no visible rash to explain it. This is believed to be caused by the release of histamine and other signaling molecules by eosinophils and other immune cells responding to the tumor.
When lymphoma spreads to the bone marrow, it can cause the marrow to stop making enough healthy blood cells. This can lead to tiredness and pale skin from anemia (low red blood cells), more infections from low white blood cells, and easy bruising or bleeding from low platelets. A rare but specific sign in Hodgkin Lymphoma is pain in swollen lymph nodes right after drinking alcohol.
The ultimate cause of lymphoma lies in the DNA of the lymphocyte. The process of generating an immune system requires B cells and T cells to cut and splice their own DNA to create unique antibodies and receptors. This natural process of DNA breakage and repair is inherently risky. If an error occurs during this shuffling, oncogenes (genes that promote cell growth) can be accidentally activated, or tumor suppressor genes (genes that stop cell growth) can be deleted.
Many B-cell lymphomas are marked by chromosomal translocations, where a piece of one chromosome attaches to another. In Burkitt Lymphoma, for example, the MYC gene from chromosome 8 moves next to the immunoglobulin gene on chromosome 14. Because B cells make lots of immunoglobulins, this change puts the MYC gene under strong control, causing the cell to make too much MYC protein and divide nonstop.
Similar changes cause Follicular Lymphoma (where the BCL2 gene moves and stops cells from dying) and Mantle Cell Lymphoma (where the Cyclin D1 gene moves and speeds up cell growth). Other mutations in genes that control immune signals, like NF-kB and NOTCH, can also lead to cancer. These mistakes help the cancer cells survive and avoid the body’s normal controls.
Certain infections play a big role in causing some types of lymphoma. The Epstein-Barr Virus (EBV), part of the herpesvirus family, was the first virus found to cause cancer in humans. EBV infects B cells and can make them multiply. Most people have EBV without problems, but in some cases—like Burkitt Lymphoma or after a transplant—the virus stops B cells from dying, which can lead to cancer. EBV is also found in many Hodgkin Lymphoma tumors.
Human Immunodeficiency Virus (HIV) does not directly cause cancer, but it destroys T cells and weakens the immune system. This makes it easier for other viruses, like EBV or HHV-8 (which causes Primary Effusion Lymphoma), to cause problems and raises the risk of aggressive B-cell lymphomas. Human T cell Leukemia Virus type 1 (HTLV-1) is another virus that can enter T cell DNA and cause Adult T cell Leukemia/Lymphoma.
Some bacterial infections can also lead to cancer. Helicobacter pylori, the bacteria that causes stomach ulcers, creates long-term inflammation in the stomach. This ongoing irritation can make B cells in the stomach lining change and become cancerous, leading to Gastric MALT Lymphoma. Treating the infection with antibiotics can often cure this type of lymphoma. Other risk factors include exposure to certain pesticides and herbicides (especially in farm workers) and autoimmune diseases like Sjogren’s syndrome or Hashimoto’s thyroiditis, which cause long-term inflammation.
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Night sweats in lymphoma are caused by the body’s reaction to the cancer. The lymphoma cells produce chemical signals (cytokines) that reset the body’s thermostat in the brain. Additionally, the tumor’s rapid growth consumes a lot of energy and generates heat. The body sweats profusely to cool down, typically during sleep.
A reactive node (from an infection) is usually tender, soft, movable, and resolves after the infection clears (usually within 2-3 weeks). A lymphoma node is typically painless, feels hard or rubbery like an eraser, may be fixed in place, and persists or grows larger over time without signs of infection.
Yes, specifically Cutaneous T Cell Lymphomas like Mycosis Fungoides. These cancers start in the skin’s T cells and appear as dry, red, itchy patches or plaques. They are often mistaken for eczema or psoriasis initially, but do not respond to standard creams and persist for long periods.
Having a first-degree relative (parent, sibling, child) with lymphoma does slightly increase the risk, suggesting a minor genetic predisposition or shared environmental factors. However, the overall risk remains low, and most people with lymphoma have no family history of the disease. It is not considered a strongly hereditary cancer like breast cancer (BRCA).
Yes, profound fatigue is widespread. It can be caused by the cancer consuming the body’s energy, by anemia if the bone marrow is involved, or by the inflammatory chemicals the body produces to fight the tumor. This fatigue is often not relieved by sleep and impacts daily functioning.
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