Non-Hodgkin lymphoma physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Preeti Singh, M.B.B.S.[2]

Overview[edit | edit source]

Common physical examination findings of non-Hodgkin lymphoma include fever, pruritus, petechiae, chest tenderness, abdominal tenderness, hepatomegaly, splenomegaly, peripheral lymphadenopathy, seizures, and central lymphadenopathy.

Physical Examination[edit | edit source]

Physical examination of patients with Non Hodgkin Lymphoma is usually remarkable for fever, pruritus, petechiae, chest tenderness, abdominal tenderness, hepatomegaly, splenomegaly and peripheral lymphadenopathy.^[1][2][3]

Appearance of the Patient[edit | edit source]

• Patients with Non Hodgkin Lymphoma usually appear cachectic
• Pemberton's sign: development of suffusion, plethora, or duskiness upon elevation of the arms above the head in patients with superior vena cava (SVC) syndrome.

Vital Signs[edit | edit source]

• Low to high-grade fever
• Tachypnea
• Kussmal respirations may be present in advanced SVCS.
• Asymmetric pulse

Skin[edit | edit source]

• Skin examination of patients with Non Hodgkin Lymphoma include:
  • Pallor
  • Pruritus
  • Petechiae
  • Single or localized cluster of erythematous skin nodules
  • Superficial ulcers

HEENT[edit | edit source]

• Abnormalities of the head/hair may include:
  • Icteric sclera
  • Nystagmus
• Patient with superior vena cava syndrome present with:
  • Facial tenderness
  • Swelling of the face
  • Facial flushing/redness face or cheeks
  • Drooping eyelid
  • Swelling around the eye
  • Swelling of the whites of the eyes

Neck[edit | edit source]

• Cervical lymphadenopathy may be present
• Jugular venous distension
• Hepatojugular reflux

Lungs[edit | edit source]

• Thoracic masses suggestive of central lymphadenopathy
• Chest tenderness
• Pleural effusion may be present and manifestations may include:
  • Lungs are hyporesonant
  • Decreased breath sounds
  • Asymmetric chest expansion
  • Wheezing

Heart[edit | edit source]

• Cardiovascular examination of patients with Non Hodgkin Lymphoma is usually normal.

Abdomen[edit | edit source]

• Abdominal examination of patients with Non Hodgkin Lymphoma include:
  • Abdominal distension
  • Abdominal tenderness
  • Abdominal mass
• Hepatomegaly
  • splenomegaly

Back[edit | edit source]

• Back examination of patients with Non Hodgkin Lymphoma is usually normal.

Genitourinary[edit | edit source]

• Genitourinary examination of patients with Non Hodgkin Lymphoma is usually normal.

Neuromuscular[edit | edit source]

• Neuromuscular examination of patients with Non Hodgkin Lymphoma is usually normal.

Extremities[edit | edit source]

• Extremities examination of patients with Non Hodgkin Lymphoma include:
  • Peripheral lymphadenopathy
  • Joint pain

CNS[edit | edit source]

• Seizures

Head[edit | edit source]

• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]
• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]

Neck[edit | edit source]

• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]
• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]
• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]
• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]
• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]
• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]
• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]
• 
  :Non hodgkin's lymphoma. Adapted from Dermatology Atlas.^[4]

References[edit | edit source]