Non-Hodgkin lymphoma physical examination

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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]

1. ↑ Hingorjo MR, Syed S (2008). "Presentation, staging and diagnosis of lymphoma: a clinical perspective". J Ayub Med Coll Abbottabad. 20 (4): 100–3. PMID 19999217.
2. ↑ Thacker N, Bakhshi S, Chinnaswamy G, Vora T, Prasad M, Bansal D; et al. (2017). "Management of Non-Hodgkin Lymphoma: ICMR Consensus Document". Indian J Pediatr. 84 (5): 382–392. doi:10.1007/s12098-017-2318-0. PMID 28378140.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
3. ↑ Armitage JO, Gascoyne RD, Lunning MA, Cavalli F (2017). "Non-Hodgkin lymphoma". Lancet. 390 (10091): 298–310. doi:10.1016/S0140-6736(16)32407-2. PMID 28153383.CS1 maint: Multiple names: authors list (link)
4. ↑ 4.00 4.01 4.02 4.03 4.04 4.05 4.06 4.07 4.08 4.09 "Dermatology Atlas".