Nurse speaking with older female patient

Follicular lymphoma is a type of cancer affecting the lymphatic system, a network of tubes (lymph vessels) that carry fluid (lymph) throughout the body with the goal of fighting infections and disease. It is a fairly common subtype of B-cell lymphoma, which is a type of non-Hodgkin lymphoma. Compared to other malignancies, follicular lymphoma is a relatively slow-growing type of cancer.

Follicular lymphoma symptoms

Some of the most common symptoms of follicular lymphoma include:

Painless swelling of the lymph nodes (often within the neck, armpits or groin)
Fever
Fatigue
Sweating and chills, particularly at night
Frequent infections
Unexplained weight loss (many people with this malignancy lose at least 10% of their body weight)

Some follicular lymphoma patients also experience unexplained itching, although this is not as common as the symptoms listed above. It’s important to note that follicular lymphoma often does not produce any noticeable symptoms. In fact, many people are diagnosed with this malignancy before ever experiencing the signs of follicular lymphoma, when they’re being treated for an unrelated health concern.

Follicular lymphoma causes and risk factors

Researchers are still working to identify the exact cause of follicular lymphoma. Studies show that this malignancy results from the body’s production of abnormal B lymphocytes—which can build up within the lymph nodes and other organs—but scientists are still trying to determine why this happens. Many believe that genetic, immunologic and environmental factors may all be at play.

Certain risk factors can make a person more likely to develop follicular lymphoma, including being over the age of 65 and being a woman. It’s important to remember that having one or more risk factors does not necessarily mean that someone will develop follicular lymphoma at any point during their life. Many people have follicular lymphoma risk factors present and never develop the malignancy, while others experience the condition without having any known risk factors.

Follicular lymphoma diagnosis

Diagnosis of follicular lymphoma often begins with a physical examination. During this appointment, a physician will speak with the patient about their personal and family medical histories and discuss any symptoms they may have been experiencing. If the physician suspects a malignancy, they may order one or more of the following follicular lymphoma tests to confirm the diagnosis:

Lymph node biopsy
Blood testing
Bone marrow biopsy
Computed tomography (CT) scan
Positron emission tomography (PET) scan

Follicular lymphoma stages

After diagnosing follicular lymphoma, a physician will need to determine how far the malignancy has progressed. Follicular lymphoma staging (sometimes referred to as “follicular lymphoma grading”) involves assigning one of the following four stages based on factors such as where the malignancy is located and how rapidly it is spreading:

Stage 1 follicular lymphoma – This describes cancer that either (1) is in only one lymph node area or lymphoid organ (for example, the tonsils); or (2) is in only one area of a single organ outside the lymph system.
Stage 2 follicular lymphoma – This refers to cancer that either (1) is in at least two groups of lymph nodes on the same side of the diaphragm (above or below); or (2) is in a group of lymph nodes and one area of a nearby organ (it may also extend to other groups of lymph nodes on the same side of the diaphragm).
Stage 3 follicular lymphoma – This characterizes cancer that either (1) is in lymph node areas on both sides of the diaphragm; or (2) is in the spleen and lymph nodes above the diaphragm.
Stage 4 follicular lymphoma – This describes cancer that has already spread to at least one organ outside the lymph system (for example, the bone marrow).

Staging of follicular lymphoma is a critical step in the diagnostic and treatment process because it enables the physician to develop a treatment plan that’s customized to the patient’s specific condition.

Follicular lymphoma treatment

As of this time, there is no cure for follicular lymphoma. However, there are various treatment options that have the potential to help patients achieve remission. In some instances—such as when a patient is in good overall health and isn’t experiencing any signs or symptoms of follicular lymphoma—physicians will recommend holding off on treatment and instead taking a watchful waiting approach (sometimes referred to as “active surveillance”). When this happens, the provider continues regularly monitoring the patient’s condition for any changes in symptoms or overall health, which could signal the need for more aggressive therapies.

Some of the most common follicular lymphoma treatment options include:

Bone marrow transplantation
Chemotherapy
Immunotherapy
Monoclonal antibody therapy
Radiation therapy
Targeted therapy

Unfortunately, despite providers’ best treatment efforts, it’s not uncommon for follicular lymphoma to return. The relatively high relapse rate makes it critical that patients carefully follow any instructions provided to them by their treatment team, attend any scheduled follow-up appointments and continue monitoring themselves for any noticeable changes.

Treatment for follicular lymphoma at Moffitt

For diagnosis and treatment of follicular lymphoma, turn to the experts at Moffitt Cancer Center. Our Malignant Hematology Program includes a wide array of follicular lymphoma specialists—such as surgeons, medical oncologists, radiation oncologists, radiologists and many others—and our patients benefit from having access to the latest treatment breakthroughs.

Contact Moffitt Cancer Center today to learn more about our highly individualized approach to treating follicular lymphoma. You can call us at 1-888-663-3488 or fill out our new patient registration form online—no referral is required. We understand how important it is to act quickly when diagnosing and treating malignancies like follicular lymphoma, so we’ll connect you to a cancer expert as soon as possible.