From the Guidelines
Lymphoma in the neck typically presents as painless, firm, and enlarged lymph nodes that persist for several weeks without resolving, and may be accompanied by symptoms such as unexplained weight loss, persistent fever, night sweats, fatigue, itchy skin, and shortness of breath. The symptoms of lymphoma in the neck can vary, but common presentations include:
- Painless, firm, and enlarged lymph nodes that persist for several weeks without resolving
- Unexplained weight loss
- Persistent fever
- Night sweats
- Fatigue
- Itchy skin
- Shortness of breath
- Pain in the lymph nodes after consuming alcohol, particularly associated with Hodgkin lymphoma
- Difficulty swallowing, voice changes, or facial swelling as the lymphoma progresses and causes pressure on surrounding structures in the neck.
According to the study by 1, patients with lymphoma may present with fever, chills, night sweats, unexplained weight loss, painless regional or diffuse lymphadenopathy, fatigue, bone pain, and/or irritability. Additionally, tumors in the head and neck may be associated with swollen glands, swelling in the neck, jaw, gingival area, or maxilla, difficulty swallowing, choking, and/or vision changes.
It's essential to note that while these symptoms can indicate lymphoma, they may also be caused by less serious conditions like infections. However, lymph nodes that continue to enlarge or persist for more than two weeks without obvious infection should prompt medical evaluation, as early diagnosis significantly improves treatment outcomes, as recommended by 1.
The diagnosis of lymphoma always requires a lymph node biopsy, and staging and risk assessment should be carried out according to the Ann Arbor classification, considering defined clinical risk factors, as stated in 1.
A comprehensive staging procedure, including bone marrow biopsy and CT scans of the abdomen and thorax, is necessary, as well as a baseline positron emission tomography (PET) scan, whenever available, as recommended by 1.
Overall, it's crucial to prioritize medical evaluation for persistent or enlarging lymph nodes in the neck, as early diagnosis and treatment can significantly improve outcomes for patients with lymphoma.
From the Research
Symptoms of Lymphoma in the Neck
The symptoms of lymphoma in the neck can vary depending on the type and stage of the disease. Some common symptoms include:
- A lump or swelling in the neck, which can be painful or painless 2
- Neck pain, which can be a common reason for seeking medical attention 3
- Enlarged lymph nodes in the neck, which can be homogeneous and variable in size 4
- A submucosal mass accompanied by polypoid, bulky masses with a smooth mucosal surface in extranodal sites such as the nasopharynx, Waldeyer ring, oral cavity, and larynx 4
- Destruction of the maxilla, mandible, and bones around the paranasal sinuses, which can be indistinguishable from bony destruction in other malignant tumors 4
Diagnosis and Evaluation
Diagnosis of lymphoma in the neck typically involves a combination of physical examination, laboratory testing, and imaging studies such as CT and MR imaging 2, 4, 5. Fine-needle aspiration cytology or biopsy may also be performed to confirm the diagnosis 2.
Types of Lymphoma
There are different types of lymphoma that can affect the neck, including:
- Hodgkin lymphoma (HL), which is most commonly located in the lymph nodes of the neck and mediastinum 4
- Non-Hodgkin lymphoma (NHL), which can present in extranodal sites such as the nasopharynx, Waldeyer ring, oral cavity, and larynx 4
- Angiocentric lymphoma, which can involve the nasal cavity and other sites in the head and neck 6
- Diffuse large B-cell lymphoma, which can occur in the paranasal sinuses, mandible, maxilla, and Waldeyer ring 4