Marginal zone lymphoma (MZL) is a type of slow-growing non-Hodgkin lymphoma that arises from B-cells in the marginal zone of lymphoid tissues. Because it develops gradually, the signs and symptoms can be subtle and often overlap with other less serious conditions, making early recognition challenging. Understanding the signs of MZL involves looking at both general lymphoma symptoms and those specific to where the lymphoma develops in the body.
One of the most common signs of marginal zone lymphoma is **painless swelling of lymph nodes**. These swollen nodes usually do not cause discomfort and can appear in areas such as the neck, armpits, or groin. The swelling may persist or slowly increase over time. Unlike infections, these lymph nodes do not typically become red or tender.
In addition to lymph node enlargement, many patients experience what are called **”B symptoms”**. These include:
– **Unexplained fever** that comes and goes without an obvious cause.
– **Night sweats**, often severe enough to soak clothing or bedding.
– **Unintentional weight loss**, where a person loses more than 10% of their body weight over six months without trying.
These symptoms reflect the body’s systemic response to lymphoma and can signal more advanced disease.
Fatigue is another frequent complaint. This tiredness is not relieved by rest and can interfere with daily activities. Some people also report **itching (pruritus)** without a rash, which can be persistent and bothersome.
Because marginal zone lymphoma can arise in different parts of the body, symptoms may vary depending on the site involved:
– **Extranodal MZL (MALT lymphoma)** often affects mucosal sites such as the stomach, lungs, salivary glands, thyroid, or eyes. When the stomach is involved, symptoms may include indigestion, stomach pain, nausea, or bleeding. Lung involvement might cause cough or shortness of breath. Salivary gland or thyroid involvement can lead to swelling or discomfort in those areas.
– **Nodal MZL** primarily affects lymph nodes, so swelling without pain is typical. Sometimes, enlarged nodes can press on nearby structures causing discomfort or difficulty swallowing if in the neck.
– **Splenic MZL** involves the spleen and bone marrow. Signs include an enlarged spleen (splenomegaly), which may cause a feeling of fullness or discomfort in the left upper abdomen. This can also lead to low blood counts (cytopenias), resulting in symptoms like easy bruising, bleeding, or increased infections due to low platelets or white blood cells.
In some cases, autoimmune symptoms may appear because MZL can be associated with autoimmune disorders. This might manifest as joint pain, dry eyes or mouth, or other systemic symptoms.
Because the symptoms of marginal zone lymphoma are often vague and develop slowly, many people may not notice them until the disease is more advanced or found incidentally during routine exams or imaging for other reasons. Persistent or unexplained lymph node swelling, especially if accompanied by B symptoms or organ-specific complaints, should prompt medical evaluation.
Doctors use a combination of physical examination, blood tests, imaging studies, and biopsy of affected tissue to confirm the diagnosis. The biopsy is crucial to identify the lymphoma subtype and guide treatment.
In summary, the signs of marginal zone lymphoma include painless swollen lymph nodes, B symptoms (fever, night sweats, weight loss), fatigue, itching, and symptoms related to the specific organ involved such as stomach discomfort, cough, or spleen enlargement. Because these signs can be subtle and overlap with other conditions, ongoing symptoms or unexplained findings warrant medical attention for proper diagnosis.
