Lymphoma is a blood cancer in which white blood cells called lymphocytes develop abnormally and grow out of control. There are two main types of lymphoma: Hodgkin lymphoma (HL), also called Hodgkin disease or Hodgkin’s disease) and non-Hodgkin lymphoma (NHL, also called non-Hodgkin’s lymphoma). Both types of lymphoma are cancers of the lymphatic system, which is part of the body’s immune system.

The lymphatic system includes the bone marrow, spleen, lymph nodes, and thymus, working together to filter out bacteria, viruses, waste, and excess fluids. Lymphoma shares similarities with other blood cancers, like leukemia and myeloma.

Common symptoms of HL and NHL often overlap and may resemble those of colds or flu. The Lymphoma Research Foundation advises seeing a doctor if symptoms last over two weeks or disrupt daily life. It’s also possible to have HL or NHL with mild or no symptoms until the cancer advances.

Common Symptoms of Lymphoma

Lymphoma symptoms will vary depending on where the cancer started, which parts of your body are affected, and the type of lymphoma you have. Lymphoma symptoms can be local or systemic. Local symptoms affect a specific area of the body, while systemic symptoms are more general or affect the entire body.

What Is Usually the First Symptom of Lymphoma?

Initial symptoms of lymphoma vary based on your lymphoma type, location, and stage. Some people with HL don’t notice any symptoms. For both types, one of the most common early symptoms is swollen lymph nodes. Swollen nodes feel like lumps in your neck, armpit, or groin area. A lymphoma lump on the neck typically isn’t painful.

B Symptoms: Night Sweats, Fever, Unintentional Weight Loss

People with HL and NHL can experience systemic B symptoms including:

• Unexplained weight loss — Lymphoma can cause rapid, unintentional weight loss, often leading to a loss of at least 10 percent of your body weight.
• Night sweats — Lymphoma night sweats often leave pajamas and bed sheets soaked. Sweats can also occur during the daytime.
• Fever — Lymphoma can cause a fever that’s not related to an infection.

These symptoms can also come from other medical conditions that aren’t related to lymphoma or cancer. Whether you have B symptoms plays a key role in staging lymphoma, choosing treatment, and predicting how certain types of lymphoma may progress. B symptoms can appear in both early and late stages of lymphoma.

Symptoms of Hodgkin Lymphoma

In some cases, people are diagnosed with HL after an unrelated blood test shows signs of lymphoma or during a physical examination when a doctor notices swollen lymph nodes. The following are common symptoms associated with HL:

• Swollen lymph nodes
• Coughing, breathing problems, or chest pain
• B symptoms
• Fatigue
• Alcohol sensitivity

Swollen Lymph Nodes

The most common symptom of HL is painless swelling of lymph nodes in the neck, underarms, or groin, forming lumps under the skin. This happens due to abnormal lymphocyte buildup, but infections and other cancers can also cause swollen lymph nodes.

Coughing, Breathing Problems, or Chest Pain

Some people experience a cough or difficulty breathing if lymph nodes in the chest swell and put pressure on the trachea (windpipe). Individuals may also have pain or pressure in the chest for the same reason. Shortness of breath can be the result of anemia (low red blood cell count). Anemia can be a sign of cancer cells in the bone marrow. Approximately 5 percent of people have HL cells in their bone marrow when diagnosed with HL.

B Symptoms

These can be caused by the immune system’s response to lymphoma cells. About 30 percent of people with HL will experience B symptoms or other systemic symptoms.

Fatigue

Cancer fatigue is more than just feeling tired. It’s a deep exhaustion that doesn’t improve, even with plenty of rest. This type of fatigue can also be a symptom of anemia, which may develop with cancer.

Alcohol Sensitivity

Sometimes people with HL notice itchy skin or an enlarged lymph node with pain after drinking alcohol. Lymphoma itching and lymph node pain may be related to an enlarged spleen or blood flow changes in response to drinking.

Read more about the signs and symptoms of Hodgkin lymphoma.

Symptoms of Non-Hodgkin Lymphoma

Many of the symptoms of HL also occur in NHL. These include:

• Swollen lymph nodes, an early warning sign of NHL
• Coughing, breathing difficulty, and chest pain as a result of pressure from swollen lymph nodes
• B symptoms or other systemic symptoms

Systemic symptoms occur in about a third of people with high-grade NHL, according to Lymphoma Action. Sudden weight loss can be an early warning sign of NHL.

The following symptoms are also associated with NHL, though not everyone with NHL will experience all of them:

• Swollen abdomen
• Gastrointestinal symptoms, including nausea, vomiting, loss of appetite, and abdominal pain
• Frequent infections
• Neurological (nerve-related) symptoms, including headache, weakness, personality changes, cognitive issues, and vision changes
• Depression and anxiety

Swollen Abdomen

A swollen abdomen may be the result of enlarged lymph nodes, accumulated fluid, or an enlarged liver or spleen. Swelling in the stomach may indicate that the lymphoma started there or has spread to this area.

Gastrointestinal Symptoms

Nausea, vomiting, loss of appetite, and abdominal pain can indicate swollen lymph nodes in the abdomen or an enlarged spleen. Enlarged lymph nodes in the abdomen and an enlarged spleen can put pressure on the stomach or other nearby organs. This pressure can reduce appetite or cause pain.

Frequent Infections

A person with NHL may experience frequent infections because of decreased white blood cell counts. Low white blood cell counts can be a sign that cancer cells are in the bone marrow.

Neurological Symptoms

Neurological symptoms can include headaches, personality changes, or cognitive issues like fuzzy thinking, which may suggest primary brain lymphoma. Symptoms such as blurry or double vision, facial numbness, or problems speaking may occur if lymphoma involves the brainstem, cranial nerves, or spinal cord.

Depression and Anxiety

Symptoms of depression are common among people with cancer. According to the National Cancer Institute, up to 25 percent of people with cancer experience depression. Depression may be triggered by the stress and worry that can come with a cancer diagnosis or from the challenges of living with a chronic medical condition.

Reach out to your health care team if you’re experiencing symptoms of depression. Treating depression has benefits for people living with cancer, and may even improve outcomes. Treatment options for depression may include medications and psychotherapy. A support network of family, friends, support groups, and online communities like MyLymphomaTeam can help you cope with the emotional challenges of cancer.

Lymphoma Symptom or Treatment Side Effect?

In addition to symptoms of lymphoma itself, you may experience side effects from lymphoma treatments like chemotherapy, radiation therapy, stem cell transplants, or other therapies. Common side effects of lymphoma treatment include:

• Hair loss
• Nausea and vomiting
• Fatigue
• Brain fog (sometimes called “chemo brain”)
• Peripheral neuropathy (often experienced as pins-and-needles sensations or numbness)
• Anemia

Other side effects are associated with newer therapies, including chimeric antigen receptor (CAR) T-cell therapy. CAR T-cell therapy trains white blood cells in the immune system to attack cancer cells. Serious side effects can come from CAR T-cell therapy including:

• Cytokine release syndrome, an immune response that causes high fever
• Dizziness
• Tiredness
• Muscle pain

CAR T-cell therapy can also cause nervous system problems like confusion, seizures, and trouble balancing.

Immunotherapy, a newer cancer treatment, can cause side effects such as fever, fatigue, and body aches that feel like flu symptoms. Medications like pembrolizumab (Keytruda) and nivolumab (Opdivo) may also overstimulate the immune system, leading to side effects that resemble autoimmune diseases. These symptoms can vary depending on which part of the body is affected — for example, some people may have joint inflammation that feels like arthritis.

Symptoms of lymphoma and treatment side effects may vary widely from person to person. Always report new or worsening symptoms or side effects to your doctor. Many symptoms and side effects can be managed with medications or lifestyle changes.

Can Lymphoma Be Cured?

The main goal of HL treatment is to cure it. More than 80 percent of people with HL can be cured through lymphoma treatment, and the cure rate is higher among younger people.

NHL treatment aims to put the cancer into remission by destroying as many cancer cells as possible.

Supportive treatments, which may be part of your treatment plan, can help minimize your lymphoma symptoms and any side effects you experience from cancer treatment.

Find Your Team

On MyLymphomaTeam, the social network for people with lymphoma and their loved ones, more than 20,000 members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.

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