B-Cell Lymphoma Clinical Presentation

Updated: Mar 31, 2023
  • Author: Mohammad Muhsin Chisti, MD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
  • Print

History and Physical Examination

Lymphadenopathy is the most common manifestation of lymphoma. Lymphadenopathy may wax and wane. Spontaneous remissions have been documented, most commonly in patients with low-grade lymphomas.

Systemic symptoms (B symptoms) known to be associated with adverse prognosis include the following:

  • Unexplained fevers
  • Night sweats
  • Weight loss

Organ-specific symptoms that may lead to identification of specific sites of involvement include the following:

  • Shortness of breath, chest pain, cough
  • Abdominal pain and distention
  • Bone pain
  • Central nervous system (CNS) symptoms

Typical physical examination findings include the following:

  • Pallor (suggesting anemia)
  • Purpura, petechiae, or ecchymoses (suggesting thrombocytopenia)

Findings in patients with an advanced high-grade lymphoma may include the following:

  • High fever
  • Tachycardia
  • Respiratory distress

Examples of findings that might direct further investigations and subsequent therapy include the following:

  • Pharyngeal involvement
  • Thyroid mass
  • Evidence of pleural effusion
  • Abdominal mass
  • Testicular mass
  • Cutaneous lesions