Most often, lymphoma is suspected following the finding of painless lymphadenopathy. Occasionally, with the more aggressive types, there may be associated pain and redness affecting the overlying skin. Differentiation from infection is important and patients have often received a course of antibiotics prior to undergoing a biopsy. Depending on the location, there may be symptoms related to organ compromise. Chest pain, pressure, or shortness of breath may occur with intrathoracic disease. The superior vena cava syndrome, with massive head and neck swelling, can occur with rapidly growing or bulky mediastinal adenopathy. Abdominal pain and swelling may occur with intra-abdominal lymphadeno-pathy. Splenomegaly may be associated with left upper quadrant discomfort and early satiety. Hydronephrosis may result from ureteral obstruction. Systemic symptoms, referred to as B symptoms, include fever, night sweats, and weight loss and generally are associated
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