Signs and Symptoms of Non-Hodgkin Lymphoma in Children

Childhood non-Hodgkin lymphoma (NHL) can cause many different signs and symptoms, depending on the type of NHL and where it is in the body. Common symptoms include:

• Enlarged lymph nodes (seen or felt as lumps under the skin)
• Abdominal (belly) swelling or pain
• Feeling full after eating only a small amount of food
• Shortness of breath, wheezing, or cough
• Fever
• Weight loss
• Night sweats
• Fatigue (feeling very tired)

Enlarged lymph nodes

Non-Hodgkin lymphoma may grow in lymph nodes under the skin (on the sides of the neck, in the underarm area, above the collar bone, or in the groin area). The enlarged nodes are often seen or felt as lumps under the skin and are not usually painful. They are often first noticed by the child, parent, or a health care provider.

Enlarged lymph nodes in children are more often caused by infections than by NHL. Lymph nodes that grow in reaction to infection are called reactive nodes or hyperplastic nodes and are often tender to the touch.

Lymphoma in the abdomen (belly)

Lymphoma growing inside the abdomen can cause swelling or pain in the abdomen. There may also be a buildup of fluid that causes even more swelling.

Lymphoma can sometimes enlarge the spleen, which might then press on the stomach. This can cause a loss of appetite and feeling of fullness after only a small meal.

When lymphoma causes swelling in or near the stomach or intestines, bowel movements may be blocked, which may lead to belly pain, nausea, and vomiting.

Lymphoma might also block urine from leaving the kidneys. This can lead to low urine output.

Lymphoma in the chest

When lymphoma starts in the thymus (a small organ in the middle of the chest) or lymph nodes in the chest, it can press on the nearby trachea (windpipe). This can lead to coughing, wheezing, shortness of breath, and trouble breathing.

The superior vena cava (SVC) is a large vein that carries blood from the head and arms back to the heart. It passes next to the thymus and lymph nodes inside the chest. Lymphomas in this area may press on the SVC, which can make the blood back up in the veins. This is can lead to swelling in the face, neck, arms, and upper chest (sometimes with a bluish-red skin color). It can also cause trouble breathing, as well as headaches, dizziness, and a change in consciousness if it affects the brain. This condition, known as SVC syndrome, can be life-threatening, so it needs to be treated right away.

Lymphoma in the brain and spinal cord

Some types of lymphoma can spread to the area around the brain and spinal cord. This can cause problems such as headache, nausea, vision changes, facial numbness, and trouble talking.

Lymphoma in the skin

Some lymphomas can affect the skin itself. They can cause itchy, red or purple lumps or nodules under the skin.

General lymphoma symptoms (B symptoms)

Along with causing symptoms in the part of the body where it starts, NHL can also cause general symptoms such as:

• Fever and chills
• Sweating (particularly at night)
• Unexplained weight loss

When talking about lymphoma, doctors sometimes call these B symptoms. B symptoms are often found in more rapidly growing lymphomas.

Sometimes lymphoma can spread to the bone marrow and crowd out the normal, healthy cells that make new blood cells. This can cause low blood cell counts and can lead to problems like:

• Severe or frequent infections (from low white blood cell counts)
• Easy bruising or bleeding (from low blood platelet counts)
• Fatigue and pale skin (from low red blood cell counts)

Many of the signs and symptoms above are more likely to be caused by something other than a lymphoma, such as an infection. Still, if your child or teen has any of these symptoms, check with the doctor so that the cause can be found and treated, if needed.