Physical Examination

A thorough physical examination of the patient should be conducted with an assessment of performance status.1

Commonly examined areas during a physical exam include1:

The lymphatic system is shown in green in the image

  • Lymph nodes
    • A survey of palpable lymph node areas throughout the body, including the axillary, femoral, and inguinal areas

The lymphoid survey3:


The lymphatic system is shown in green in the image

  • Chest
    • An assessment for pain, pressure, or symptoms of superior vena cava syndrome (SVCS) 3
  • Abdomen
    • Palpation for any masses. Assess for splenomegaly (enlarged spleen) and hepatomegaly (enlarged liver)3
  • Head and neck
    • A survey for palpable nodes, including assessment of Waldeyer’s Ring3
  • Extranodal sites
    • Central nervous system (CNS)3
    • Gastrointestinal (GI) tract3
    • Skin abnormalities, such as rashes and lumps, may be subtle3
    • Mucosal abnormalities (eg, mucosa-associated lymphoid tissue [MALT] lymphomas)3
      • Note: Nongastric sites, such as eyes and skin, should be assessed during the physical exam for gastric MALT lymphoma1

References: 1. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for B-Cell Lymphomas V.4.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed July 10, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. 2. Merck Manual. 20th ed. Lane KAG, ed. Rahway, New Jersey: Merck & Co., Inc. 2018. 3. Freedman AS, Friedberg, JW, Aster JC. Clinical presentation and diagnosis of non-Hodgkin lymphoma. UpToDate. https://www.uptodate.com/contents/clinical-presentation-and-diagnosis-of-non-hodgkin-lymphoma. July 28, 2017.