Which physical findings are characteristic of pediatric non-Hodgkin lymphoma (NHL)?

Updated: Jun 14, 2018
  • Author: J Martin Johnston, MD; Chief Editor: Max J Coppes, MD, PhD, MBA  more...
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Answer

Patients with non-Hodgkin lymphoma generally appear mildly to moderately ill. They occasionally have a low-grade fever. Patients may present with pallor, respiratory distress, pain, and discomfort.

A jaw or orbital mass is present in as many as 10% of patients in industrialized countries, but this finding is particularly common in African patients with endemic Burkitt lymphoma.

Other clinical findings in non-Hodgkin lymphoma include the following:

  • Cervical or supraclavicular masses or adenopathy is/are firm, fixed, and nontender

  • Dyspnea or stridor may occur in patients with a mediastinal mass

  • In patients with superior vena cava syndrome, distended neck veins and plethora may be observed

  • Decreased breath sounds are secondary to bronchial obstruction or pleural effusion

  • Thoracic dullness to percussion may be present with pleural effusion.

  • Abdominal distention or a mass may be present with or without tenderness, rebound tenderness, and/or shifting dullness

  • Painful skin lesions suggest an anaplastic large cell lymphoma (LCL); the less common forms of cutaneous lymphoma (T-cell, blastic plasmacytoid dendritic) are typically nontender

  • Obtundation, agitation, and meningismus may be observed in individuals with CNS involvement.

  • Focal pain or swelling in the extremity may be present in patients with primary bone lymphoma.

Relatively uncommon physical findings include the following:

  • Nasopharyngeal mass

  • Parotid enlargement

  • Nephromegaly

  • Testicular enlargement


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