Follicular lymphoma is a cancer of the B-cells that accounts for around one third of all cases of lymphoma. The cancer is a form of non-Hodgkin lymphoma that usually affects adults, with an average age-at-diagnosis of 60. Follicular lymphoma is more common among women than among men.

Causes

The causes of follicular lymphoma are not yet known and the disease is not infectious or transmissible between humans. The cancer cannot be transmitted from one person to another.

Signs and symptoms

The cancer usually begins with painless swelling in the lymph nodes of the neck, armpit or groin. Other symptoms include fatigue, unexplained weight loss, loss of appetite, fever and night sweats.

Diagnosis

Diagnosis is based on the results of a biopsy taken from the enlarged lymph tissue, which is examined under a microscope for the presence of cancer cells. Further tests including blood tests, X-ray and bone marrow sampling may be performed to ascertain the type of lymphoma and how widespread it is.

Staging and treatment

Once the cancer is identified, it is staged to help determine the most appropriate therapy as well as helping to predict patient outcome in response to therapy. The stage of non-Hodgkin lymphoma is defined by how many lymph nodes are involved, where they are located and whether it has spread to other organs such as the bone marrow or liver. The cancer is categorized into four stages, where stage 1 describes a cancer that involves only one group of lymph nodes and stage 4 describes lymphoma that has spread beyond the lymph nodes and involves other organs.

Treatment is started when the cancer becomes symptomatic. If the lymphoma is not causing symptoms, treatment may be withheld and the patient monitored closely instead for growth and/or spread of the cancer.

Chemotherapy is often given in combination with an immunomodulating agent called rituximab, which is a monoclonal antibody. Stem cell transplants are also useful. If the lymphoma is stage 1 or 2, radiotherapy alone is often sufficient to treat the cancer.