Symptoms and diagnosis of T-cell lymphoma

Common symptoms of T-cell lymphoma are:

• swollen lymph nodes (glands)
• stomach pain, feeling uncomfortably full or sick
• feeling short of breath
• extreme tiredness (fatigue)
• skin rashes.

You may also have symptoms called B symptoms, which are commonly caused by lymphoma:

• a high temperature (fever)
• losing weight without trying
• night sweats that soak your clothes and bedding.

Doctors are interested in B symptoms because it helps them decide the stage of the lymphoma and how to treat it.

We have more information about the general symptoms of non-Hodgkin lymphoma.

You will have a range of tests to help doctors diagnose which type of lymphoma you have. The main ones are:

A doctor will insert a fine needle into a lymph node to extract a small amount of tissue. You will have a local anaesthetic to numb the area beforehand. You will probably feel pressure as the needles goes in, and it may be a bit uncomfortable. If it hurts, tell your doctor so they can give you more anaesthetic.

The tissue sample then goes off to a laboratory to be checked for abnormal cells.

You will give a blood sample so that your doctor can check the number of each type of blood cell in your blood (a full blood count). You doctor may also order blood tests to check your overall health, such as how well your liver and kidneys are working.

Blood tests can also be used to look for particular genetic changes in your blood cells, which can help your doctor make an accurate diagnosis.

You may have a scan, usually a PET-CT scan, to look at where the lymphoma is in your body. A scan can also help with staging the lymphoma.

We have more information about tests to diagnose blood cancer.

Your doctor may tell you the stage of the lymphoma. This is based on where the lymphoma is in your body.

Stage 1: Only one lymph node or group of lymph nodes is affected, in one place in your body.

Stage 2: More than one group of nodes is affected but all of them are on the same side of the diaphragm, either above or below it. (The diaphragm is the sheet of muscle that separates your chest from your stomach area.)

Stage 3: Lymph nodes on both sides of the diaphragm are affected.

Stage 4: The lymphoma has spread to other organs, such as the lungs, liver or bone marrow.

Stages 1 and 2 are considered to be early stage, and 3 and 4 are late stage. Having late stage lymphoma does not mean that treatment will work less well. The aim of staging is to help your doctor decide which treatment will be best for you.

Your doctor may also add letters to the stage number to describe the lymphoma in more detail:

B means you have one or more B symptoms. B symptoms are fever, unexplained weight loss and night sweats.

A means you don’t have any B symptoms.

E means the lymphoma has extended from an affected lymph node into another organ close to it.

X means you have bulky disease – a lymph node that measures 10cm or more, or a swelling in your chest that is at least a third of its width.

S means there is lymphoma in your spleen, an organ that is part of your immune system.

So, you may be told, for example, the lymphoma is stage 2A, or stage 4BX.