When to worry about swollen lymph nodes with diffuse large B-cell lymphoma

If you are being treated for diffuse large B-cell lymphoma, tell the team about a change rather than waiting for your next routine appointment. They can decide whether you need an examination, blood tests, imaging, or a change to the treatment plan.

Swollen lymph nodes are a very common presentation of diffuse large B-cell lymphoma. During diagnosis or treatment, their size and location can help the clinical team understand how the lymphoma is behaving.

A swollen node does not by itself explain why it has changed. Infection, inflammation, a reaction after treatment, or active lymphoma can all be considered. New swelling deserves clinical assessment in the context of your symptoms, examination findings, and recent treatment.

Make a note of where the swelling is, when you first noticed it, whether it is changing, and any tenderness or skin changes. Also record fever, drenching night sweats, unexplained weight loss, fatigue, cough, or recent infection symptoms.

Do not repeatedly press or measure the node, as this can make an area sore and does not replace assessment. When you call, mention your current medicines, the date of your most recent lymphoma treatment, and whether you have a central line or other device.

Seek urgent medical care for trouble breathing or swallowing, swelling of the face or neck, chest pressure, confusion, fainting, or rapidly worsening weakness. These symptoms need urgent assessment regardless of the cause of the swelling.

Contact your treatment team the same day for a fever, shaking chills, feeling suddenly unwell, redness or warmth over a swollen area, or a new painful node. This is especially important while receiving treatment that may affect your ability to fight infection.

Ask whether the node's location or pattern changes your assessment, which symptoms should trigger an out-of-hours call, and whether an examination, scan, or blood test is needed. You can also ask how to contact the lymphoma team if symptoms develop between appointments.