Case history

Case history #1

A 55-year-old male farmer presents with worsening shortness of breath, night sweats, fevers, bilateral axillary lymphadenopathy, and a 7.7 kg (12%) total body weight loss over 3 months. Recently, he has not been able to work because of fatigue. Physical examination reveals a 3.5 cm left axillary mass, enlarged cervical, axillary, and inguinal lymph nodes, splenomegaly, and no hepatomegaly.

Case history #2

A 56-year-old woman presents with a painless right neck lump that has been slowly enlarging for the last 2 years. She denies fevers, night sweats, or weight loss. Physical examination reveals bilateral cervical and axillary adenopathy and a palpable spleen.

Other presentations

Clinical presentation is often vague and can be very diverse, ranging from asymptomatic or minimally symptomatic (e.g., painless enlarged lymph nodes) in those with an indolent NHL (e.g., follicular lymphoma) to acute presentation with an aggressive NHL (e.g., diffuse large B-cell lymphoma).

Patients with aggressive NHL or advanced-stage disease may present with the following: B symptoms (fever, night sweats, and weight loss); fatigue/malaise; chest pain; shortness of breath; cough; abdominal discomfort or pain; headache/change in mental status; focal neurological deficits (e.g., ataxia, cognitive changes, and focal weakness); bone pain; back pain; breast pain; or metabolic abnormalities (acute renal failure, tumour lysis syndrome, hypercalcaemia).[3][4][5][6][7][8][9][10][11][12][13]​​​​[14][15]​​

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