From a small node in the neck area, the 55-year-old woman faced a tumor larger than 10 cm, causing pain spreading to the head and shoulders due to compression of nerve structures. After surgery to remove the specimen, histology results determined that the patient had non-Hodgkin lymphoma.
MSc.BS Pham Thanh Thuong, an oncology surgeon at An Viet General Hospital, said that this is a noteworthy case because the initial manifestations of the disease are quite silent and easily confused with common diseases.
From April 2026, the patient voluntarily felt an abnormal lymph node in the neck area. The patient has been examined at many medical facilities but the cause has not been determined. The patient had been treated with antibiotics, but the lymph node mass not only did not improve but continued to develop.
Recently, the lymph node mass has grown rapidly, reaching a diameter of more than 10 cm. The rapid increase in tumor size causes pain spreading to the head and shoulder blades, which is believed to be related to the compression of adjacent nerve structures.
Notably, patients also experience systemic symptoms such as weight loss, mild fever at night and night sweats when sleeping.
After examination and performing necessary diagnostic steps, doctors decided to perform surgery to remove the specimen to determine the nature of the injury. The results of histology later determined that the patient had non-Hodgkin's lymphoma.
According to Dr. Pham Thanh Thuong, non-Hodgkin's lymphoma is a malignant disease group of the lymphocyte system, originating from B, T or T/NK lymphocytes. This is not a single disease but a very diverse group of diseases in terms of histological characteristics, clinical manifestations, progression rate, prognosis and treatment methods.
One of the common signs is abnormally large lymph nodes. Nodes can appear in the neck, armpits, groin or deep in the abdominal cavity, chest cavity.
It is noteworthy that not all swollen lymph nodes are cancerous. The lymph nodes can be swollen due to infection or many other benign causes. However, cases where lymph nodes persist for a long time, increase in size rapidly or do not respond to conventional treatment need to be carefully assessed.
In particular, when lymph nodes develop rapidly, become large in size or appear with systemic symptoms, patients need to be examined by a specialist to find the cause, instead of self-treatment or prolonged antibiotic use," Dr. Thuong recommended.
The progression of lymphoma is also very different depending on the disease type. Some slow-progressing forms can be silent for a long time, making patients subjective and only detected when the disease has progressed. Meanwhile, forms with high levels of malignancy can develop rapidly, causing systemic symptoms and life-threatening if not diagnosed and treated promptly.
According to Dr. Pham Thanh Thuong, lymphomas need to be identified by histopathology, in many cases prioritizing complete lymph node biopsy. Surgery is mainly aimed at obtaining diagnostic specimens, while systemic treatment usually plays the main role.
Lymph nodes that are prolonged, rapidly larger, larger in size, accompanied by fever, night sweats or weight loss need specialized examination. Patients should not self-medicate with prolonged antibiotics. Biopsies and tissue pathological tests help identify the cause and early detection of lymphoma.
