Dominic Stone
Non-Hodgkin lymphoma (NHL) is a group of blood cancers that develop in the lymphatic system, which is a network of vessels and glands (lymph nodes) throughout the body. It is one of two types of lymphoma—cancers that start in white blood cells called lymphocytes, which are important immune system cells that help fight off infections. Lymphomatous involvement of muscles has been reported to occur in only 1.4% of cases, with 1.1% occurring in Non-Hodgkin Lymphoma. However, there are reported cases of patients with non-hodgkin lymphoma presenting with muscle pain, especially in the lumbar spine, resulting in lumbar radiculopathy.
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What You'll Learn
- Non-Hodgkin lymphoma (NHL) is a group of blood cancers that develop in the lymphatic system
- Lymphomas in the stomach or intestines can cause abdominal pain
- Lymphomas in the thymus or chest lymph nodes can cause chest pain
- Lymphomas can spread to the area around the spinal cord, causing back pain
- Muscle involvement by non-Hodgkin lymphoma is rare, usually occurring as a result of metastatic spread
Non-Hodgkin lymphoma (NHL) is a group of blood cancers that develop in the lymphatic system
NHL is the seventh most common cancer in the United States and the eleventh most common worldwide. It is much more common than Hodgkin lymphoma, with NHL accounting for 80-90% of lymphoma cases. The most common symptom of NHL is a painless swelling of the lymph nodes in the neck, underarm, or groin. However, it can also present as seemingly uncomplicated musculoskeletal complaints, such as low back pain and radiculopathy, shoulder strain, rotator cuff tendinitis, and chronic piriformis myofascial pain syndrome with sacroiliac joint dysfunction.
While musculoskeletal involvement is rare, occurring in only about 1.4% of cases, it is usually the result of metastatic spread from adjacent lymph nodes or other primary sources such as bone. Lymphoma spreads by infiltration of malignant cells that lack extracellular stroma and intercellular junctions, resulting in diffuse enlargement of involved structures and passing fascial boundaries. This can lead to the involvement of more than one muscle compartment, as seen in imaging studies such as CT and MR scans.
Involvement of the skeletal muscles by NHL is unusual, with the most commonly affected muscles being those of the extremities, pelvis, and gluteal regions. Primary skeletal muscle lymphoma is a rare disease, accounting for only 0.5-1.5% of all extranodal lymphomas. However, when it does occur, it can cause pain and other symptoms such as swelling, weight loss, and loss of appetite. Treatment for NHL typically involves chemotherapy, and in some cases, complete regression of the lymphoma can be achieved.
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Lymphomas in the stomach or intestines can cause abdominal pain
Lymphomas are cancers of the lymphatic system, which is a widespread network of organs and tissues that are part of the body's immune system. Lymphomas can occur in the lymph nodes or in extranodal tissue, and they can spread to the muscles and bones.
Lymphomas in the abdomen or pelvis are common in Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). The spleen and gastrointestinal tract are some of the most common sites of extranodal lymphoma, especially in the stomach and small bowel. Lymphomas in the stomach or intestines can cause abdominal pain, nausea, or vomiting. Abdominal pain is a common symptom of gastrointestinal lymphoma, occurring in about 45% to 65% of patients. The pain stems from the presence of a growing mass, which may also cause a blockage.
Gastrointestinal bleeding can also occur in patients with lymphoma, and this can present as abdominal pain with fresh bleeding per rectum. In addition, lymphoma patients with new-onset abdominal pain must be promptly evaluated to exclude perforation, which is a significant life-threatening complication with a high morbidity and mortality rate.
Although rare, primary bone lymphoma may present with low back pain and radiculopathy as the initial manifestation of the disease. Metastatic non-Hodgkin lymphoma of the spine is also rare, occurring in less than 5% of patients. However, it is important to consider this in the differential diagnosis for patients presenting with low back pain and radiculopathy.
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Lymphomas in the thymus or chest lymph nodes can cause chest pain
Lymphomas are cancers of the lymphatic system, and they can occur in the thymus or chest lymph nodes. When lymphoma starts in the thymus or lymph nodes in the chest, it may press on the trachea (windpipe), leading to symptoms such as coughing, difficulty breathing, and chest pain or pressure. This pressure on the trachea can cause a feeling of tightness or discomfort in the chest, making it hard to take deep breaths.
Lymphomas in this area can also affect the superior vena cava (SVC), a large vein that carries blood from the head and arms back to the heart. The tumour may push on the SVC, causing blood to back up in the veins and leading to swelling in the head, arms, and upper chest. This obstruction can be life-threatening and requires immediate medical attention.
Thymomas and thymic carcinomas are rare cancers that originate in the thymus gland, located behind the breastbone. While these cancers typically don't exhibit symptoms initially, they can eventually cause chest pain or pressure as they grow and impact nearby organs in the chest. This pain may be a result of the tumour pressing on sensitive structures in the chest or causing inflammation in the area.
In addition to chest pain, lymphomas in the thymus or chest lymph nodes can also cause other symptoms, such as a persistent cough, shortness of breath, and trouble swallowing. These symptoms may indicate an obstruction or irritation in the chest cavity, requiring prompt medical evaluation. It is important to note that the presence of these symptoms does not necessarily indicate lymphoma, as they may be associated with other medical conditions. However, if you are experiencing any of these symptoms, it is always advisable to consult a healthcare professional for proper diagnosis and treatment.
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Lymphomas can spread to the area around the spinal cord, causing back pain
Lymphomas are cancers that develop in the lymphatic system, which is a network of vessels and glands (lymph nodes) throughout the body. They are broadly categorized into Hodgkin and non-Hodgkin lymphomas, with the latter being much more common and accounting for about 80-90% of cases. Non-Hodgkin lymphoma (NHL) is a group of blood cancers that arise from mutations in white blood cells called lymphocytes, which are crucial for immune function.
While lymphoma typically arises in the lymph nodes, it can occur in almost any tissue, including the muscles. Muscle involvement in lymphoma is uncommon, occurring in only about 1.4% of cases, with non-Hodgkin lymphoma affecting the muscles in about 1.1% of cases. The most common muscles affected are those in the extremities, pelvis, and gluteal regions. Muscle involvement usually occurs due to metastatic spread from nearby lymph nodes or bones.
Now, to address the core of your query, yes, lymphomas can indeed spread to the area surrounding the spinal cord, leading to potential back pain. This occurrence is rare, but it has been documented in case reports. Metastatic non-Hodgkin lymphoma of the spine can manifest as lumbar radiculopathy, causing low back pain and leg radiculopathy. This condition involves the compression of nerve roots in the lumbar spine, leading to pain and potential neurological symptoms.
In one case, a 46-year-old man experienced low back pain and right leg radiculopathy, which led to the discovery of metastatic non-Hodgkin lymphoma in the lumbar spine. Magnetic resonance imaging (MRI) scans revealed pathologic compression fractures and nerve compression. Another case report described a 32-year-old man with constant low back pain, weight loss, and anorexia, who was diagnosed with non-Hodgkin lymphoma with skeletal muscle involvement.
It is important to note that back pain can have various causes, and lymphoma is a rare cause of spinal-related back pain. However, it is crucial to consider lymphoma as a potential differential diagnosis when encountering back pain, especially when accompanied by other symptoms or signs indicative of lymphoma.
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Muscle involvement by non-Hodgkin lymphoma is rare, usually occurring as a result of metastatic spread
Lymphomas are cancers of the lymphatic system, which is a network of tissues and organs that help the body get rid of waste and fight infections. Lymphomas account for about 2% of all cancer diagnoses each year and are ranked as the sixth most common cancer type in Ireland. There are two types of lymphoma: Hodgkin and non-Hodgkin lymphoma (NHL), with the latter accounting for the vast majority of cases (80-90%).
NHL is a group of blood cancers that develop in the lymphatic system. It includes B-cell lymphomas and T-cell lymphomas. B-cell lymphomas account for about 85% of all NHL diagnoses, while T-cell lymphomas are relatively rare. NHL typically arises in the lymph nodes, but it can occur in almost any tissue. Extranodal disease, or disease that occurs outside of the lymph nodes, is present in 25-40% of cases.
While musculoskeletal involvement in lymphoma is rare, it can occur as a result of secondary spread or primary extranodal disease. Muscle involvement by non-Hodgkin lymphoma is particularly unusual, occurring in only about 1.1% of cases. The most commonly affected muscles are those of the extremities, pelvis, and gluteal regions. This involvement typically occurs as a result of metastatic spread from adjacent lymph nodes or other primary sources such as bone.
There have been reported cases of non-Hodgkin lymphoma presenting with muscle involvement. For example, a case study described a 32-year-old man who was admitted to the hospital with low back pain, anorexia, and significant weight loss. Another case study reported a 46-year-old man who experienced low back pain and right leg radiculopathy, which was found to be caused by metastatic non-Hodgkin lymphoma in the lumbar spine. While rare, it is important to consider non-Hodgkin lymphoma as a potential cause of musculoskeletal complaints, especially when other symptoms are also present.
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Frequently asked questions
Non-Hodgkin lymphoma (NHL) is a group of blood cancers that develop in the lymphatic system. It is one of two types of lymphoma — cancers that start in white blood cells called lymphocytes. Lymphocytes are important immune system cells that help fight off infections.
The most common symptom of NHL is a painless swelling of the lymph nodes in the neck, armpits, or groin. Other symptoms include fever, fatigue, weight loss, abdominal pain, cough, and/or shortness of breath. Lymphomas in the stomach or intestines can cause abdominal pain, nausea, or vomiting.
Muscle involvement occurs in only 1.4% of lymphoma cases, with 1.1% occurring in Non-Hodgkin lymphoma. The most commonly affected muscles are those of the extremities, pelvis, and gluteal regions.
Treatment for non-Hodgkin lymphoma depends on the specific type and how advanced it is. It may include chemotherapy, radiation therapy, stem cell transplant, or targeted drug therapy.
