In the pathophysiology of NHL, normal lymphoid tissue is replaced by the malignant lymphoma, resulting in immunodeficiency and infections. The bone marrow may be replaced, resulting in pancytopenia and subsequent bleeding and infection. Tumor bulk may obstruct or invade organs, ultimately causing death. Symptoms and Signs NHL appears to be multicentric in origin and is often widespread at presentation. A leukemic phase, detectable by peripheral blood testing, may occur.
Most patients initially seek medical care because of cervical or inguinal lymph node enlargement.
Occasionally, splenomegaly, bone marrow failure, autoimmune hemolytic anemia, and autoimmune thrombocytopenia are presenting features. Waldeyer's tonsillar lymphatic ring is commonly involved in patients with GI lesions. Hypogammaglobulinemia may occur. However, occasionally a monoclonal serum M spike is found on serum protein electrophoresis and on immunoelectrophoresis. The diagnosis is made by a biopsy of a lymphatic site revealing the histologic features of malignant lymphoma.