Clinical Features

Nodal disease: typically painless lymphadenopathy associated with fatigue and weakness (multiple noncontiguous lymph nodes may be involved) [12][13]

• High grade

  • Rapidly growing mass/nodes

  • Constitutional symptoms or B symptoms (i.e., weight loss, fever, night sweats)

• Low grade

  • Slow-growing or undulant lymphadenopathy (over months or years)

  • Hepatosplenomegaly

  • Cytopenias: Patients may present with anemia or bleeding, or have an increased susceptibility to infections.

Extranodal disease (primary or secondary): The symptoms are highly dependent on the affected tissue; B symptoms are common. [12][13]

• GI tract: e.g., early satiety, GI bleeding

• Neurological involvement: e.g., headache, focal neurologic symptoms

• Primary cutaneous NHL or secondary skin infiltration: e.g., rash, plaques, tumors, ulcers

• Thyroid involvement (rare): e.g., nodules, goiter

Examples include tumor lysis syndrome, hypercalcemia, spinal cord compression, superior vena cava syndrome, cardiac tamponade, lymphomatous meningitis, and a CNS mass.