A bone marrow biopsy, performed for staging purposes, showed no evidence of lymphoma. They may notice the lymph node enlargement themselves, or a physician may detect it during a routine physical examination or as an incidental finding on a chest x-ray. In other cases, an abnormal finding on a blood test may be the first clue to the disorder. The most characteristic of these is an elevated lactic dehydrogenase level, which also has prognostic importance. Other symptoms at presentation include cough associated with a mediastinal mass or pulmonary lesion, acute or subacute superior vena cava syndrome, bone pain secondary to bone lymphoma, or neurologic symptoms caused by brain involvement.
Lymphoma can involve virtually any organ, so extranodal presentations are common.
Persons of any age may be affected, but the median age is about 64 years. As is true in most cases of non-Hodgkin's lymphoma, we have no idea. Two studies have reported a relationship with red blood cell transfusions and two studies found no such relationship. This patient had none of those risk factors. HIV infection is not only a risk factor but has therapeutic and prognostic implications as well.