A swollen lymph node or nodes is the most common symptom of lymphoma. However, there are many other possible causes of swollen lymph nodes.

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Lymph nodes in the neck, armpit or groin are close to the surface of the skin and are easy to see and feel. Others that are deep inside the chest or tummy (abdomen), can’t be felt from the outside. They might only be found on a scan. They can cause pain if they swell and press on tissues inside your body.

Swollen lymph nodes caused by lymphoma:

• are most commonly found in the neck, armpit or groin
• are usually smooth and round
• usually move out of the way when you press on them (are ‘mobile’)
• have a ‘rubbery’ texture
• are usually painless – although they can sometimes ache or cause pain in nearby areas (for example, if they’re pressing on a nerve)
• can become very large.

Rarely, swollen lymph nodes can become painful soon after drinking alcohol. This affects up to 5 in 100 people with Hodgkin lymphoma.

 

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Where might lymphoma cause swollen lymph nodes?​

Swollen lymph nodes might be in just one area of your body. This can happen with any type of lymphoma.

You might have swollen lymph nodes spread throughout your body (‘generalised lymphadenopathy’), which is more common in non-Hodgkin lymphoma than Hodgkin lymphoma.

Why does lymphoma cause swollen lymph nodes?​

Swollen lymph nodes in lymphoma are caused by a build-up of cancerous cells in the lymph nodes.

Sometimes the lymphoma is active, which means that it’s making lots of cancerous cells. At other times, it’s less active, and some of the lymphoma cells die. Lymph nodes sometimes grow (during times of high activity) and shrink (when activity is lower), especially in people with low-grade non-Hodgkin lymphoma.

 

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What else can cause swollen lymph nodes?​

There are many other possible causes of swollen lymph nodes, including:

• infections, such as coughs, tonsillitis, colds, ear and throat infections
• illness that affect the immune system, such as rheumatoid arthritis
• skin conditions, such as eczema or psoriasis
• some medicines, including penicillin, drugs used to treat epilepsy (phenytoin and carbamazepine), cephalosporins (a type of antibiotic) and the covid-19 vaccination.

 

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Chest symptoms​

Swollen lymph nodes in the chest are quite common in Hodgkin lymphoma and some types of high-grade non-Hodgkin lymphoma. However, any type of lymphoma can cause them.

Swollen lymph nodes in the chest can press on your airways and lungs. They can also cause fluid to collect around your lungs.

Swollen lymph nodes in the chest can cause symptoms such as:

• dry cough
• shortness of breath
• noisy breathing
• pain behind the breastbone
• a feeling of pressure in the chest.

These can be worse when you lie down.

If you have a cough or shortness of breath that lasts for more than 3 weeks, speak to your GP.

Swollen lymph nodes that press against blood vessels can lower the blood flow through them. This can cause swelling and, in some cases, can increase the risk of a clot forming.

 

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Tummy (abdominal) symptoms​

Lymphoma can develop in lymph nodes in the abdomen or lymphatic tissue in your liver or spleen. It can also develop outside your lymphatic system (‘extranodal’ lymphoma). The gut is the most common place for extranodal lymphoma to develop.

Symptoms depend on which parts of your body are affected. For example:

• If your spleen is very swollen, you might have pain behind your ribs on the left side, or you might feel bloated or full after eating only a little. You or your doctor might be able to feel the swollen spleen as a lump in the top left side of your tummy.
• If you have lymphoma affecting your liver, your tummy might become swollen and the whites of your eyes and your skin might develop a yellow tinge (jaundice). Lymphoma affecting your liver might also cause you to feel bloated, which can happen from a build-up of fluid in your abdomen.
• Lymphoma in the stomach can cause swelling of the stomach lining (gastritis), which can cause pain or nausea (feeling or being sick).
• Lymphoma in the bowel can cause abdominal pain, diarrhoea or constipation.

See your GP urgently if your skin or the whites of your eyes look yellow.

Speak to your GP if you have any of the following symptoms:

• blood in your poo
• a change in bowel habits (such as diarrhoea or constipation) that goes on for more than 7 days
• green or yellow vomit
• vomiting lasting more than 2 days
• vomiting that causes you to become dehydrated by being unable to drink liquids without vomiting.

 

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Pain​

Lymphoma isn’t usually painful but sometimes, swollen nodes press on other tissues and nerves which can cause pain. Lymphoma in the bone itself (rather than in the bone marrow) is rare but when it does happen, it can cause pain in the affected bone.

 

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Skin symptoms​

Lymphoma can cause itchy skin.

If you have skin lymphoma, you might have symptoms that affect your skin. Common symptoms depend on the type of skin lymphoma, but could include:

• lumps, which are often a purple colour
• patches of skin that are dry, red, scaly or itchy
• patches of skin that are different to other areas – for example, are flatter, shiny, raised, scaly or red.

Lymphoma in the skin can look a lot like other skin conditions, such as eczema or psoriasis.

If you have been diagnosed with skin lymphoma, you might be interested in our information about living with skin lymphoma.

Speak to your GP urgently if you have a rash that:

• starts suddenly and spreads quickly
• is all over your body
• comes with other symptoms such as pain, fever of breathlessness.

If you have a new rash that doesn’t go away within a few days, seek advice from your GP.

 

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Brain and nerve symptoms​

Symptoms that affect your brain and nerves depend on where the lymphoma is.

Lymphoma that affects your central nervous system (CNS)​

Central nervous system lymphoma is an uncommon type of lymphoma that is in your brain, spinal cord or eyes (your central nervous system, or CNS). Symptoms depend on where the lymphoma is, but can include:

• fits (seizures)
• problems with balance
• dizziness
• difficulties with memory and concentration
• weakness or tingling in an arm or leg.

 

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Lymphoma that affects your peripheral nervous system​

Other types of lymphoma can cause damage to the nerves outside of the brain and spinal cord (the peripheral nervous system). This is called peripheral neuropathy.

Symptoms of peripheral neuropathydepend on which group of nerves are affected. They can include:

• pins and needles, numbness or a burning sensation, often in the hands or feet
• pain
• increased sensitivity to touch or temperature
• muscle twitches (small muscle contractions).

Tell your GP if you have any of these symptoms.

Peripheral neuropathy can happen if the lymphoma produces chemicals that stick to nerves and damage them. It is quite common in people with Waldenström's macroglobulinaemia (WM).

Rarely, lymphoma spreads into the nerves. It can push up against them or grow around the tiny blood vessels that supply them. This can cause symptoms of peripheral neuropathy.

Peripheral neuropathy can also affect the nerves of your autonomic nervous system, which carry messages between your brain and your internal organs. This can cause symptoms such as blood pressure changes and light-headedness.

 

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Peripheral neuropathy

 

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Thinking processes (cognition)​

Lymphoma can affect thinking processes (cognition) such as memory, attention and speed of response. This is known as cancer-related cognitive impairment(‘chemo brain’). However, anyone with lymphoma might be affected, not only people treated with chemotherapy. Fatigue or emotional factors, such as stress and anxiety, can also have an impact.

 

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Swelling in the arms or legs (lymphoedema)​

Swollen lymph nodes can sometimes block the lymphatic vessels (tubes that run throughout your body and carry lymph fluid). This stops the lymph fluid draining properly from the tissues in your body.

The lymph fluid can then build up, causing lymphoedema (swelling in the body’s tissues). Possible symptoms include swelling, feelings of tightness, heaviness, aching or soreness. It usually affects an arm or a leg, although it can affect other areas of your body, depending on where the lymphoma is.

Other conditions can also cause lymphoedema. For example, infection, injury, genetic conditions and surgery.

If you have any symptoms of lymphoedema, speak to your GP.

 

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Anaemia​

Many people with lymphoma are affected by anaemia at some point during their illness.

Anaemia means that you have a shortage of red blood cells. This can make you feel tired and breathless because your body has to work harder than usual to get enough oxygen.

You might experience anaemia if lymphoma affects your red blood cells, for example:

• Lymphoma in the bone marrow can affect the production of healthy blood cells, leading to anaemia.
• Lymphoma in the gut can cause bleeding, which can lead to anaemia.
• If red blood cells collect in the spleen or get destroyed in the spleen, this can cause anaemia.

Symptoms of anaemia can include:

• weakness and tiredness
• dizziness
• headache
• fluttering or pounding heart (palpitations)
• a paler skin tone than is usual for you.

If you experience symptoms of anaemia, contact your GP.

There are lots of other causes of anaemia, including nutritional deficiencies (particularly iron), heavy periods, pregnancy and some infections.