Follicular Lymphoma: Symptoms, Treatment, and Outlook

Follicular Lymphoma
Follicular Lymphoma

In its early stages, follicular lymphoma frequently shows no symptoms and grows slowly. Usually, the initial sign is swelling in the lymph nodes, which are usually located in the groyne, thighs, armpits, and neck.

A class of malignancies known as lymphomas arises from the lymphatic system. This consists of:
  • lymph nodes
  • lymph vessels
  • organs like your tonsils and spleen
A subtype of non-Hodgkin's lymphoma, which is the most prevalent type of lymphoma, is follicular lymphoma. Although it grows slowly, it frequently comes back after therapy. In most cases, an enlarged lymph node is the initial sign.

This page looks at the signs, prognosis, and available treatments for follicular lymphoma.

Facts about follicular lymphoma
  • In the US, follicular lymphoma affects about 15,000 people annually.
  • About 60 years of age is the typical age at diagnosis.
  • Although follicular lymphoma seldom affects children, when it does, it affects men almost ten times more frequently than it does women.
  • With around 30% of cases, follicular lymphoma is the second most prevalent kind of non-Hodgkin's lymphoma.
  • The most typical slow-growing lymphoma is follicular lymphoma.
  • Follicular lymphoma with exposure to specific pesticides and herbicides has been related by researchers.

What are the primary symptoms of follicular lymphoma?

In its early stages, follicular lymphoma usually shows no symptoms and grows slowly. Individual differences in symptoms can be attributed to a variety of factors, including the location and stage of the malignancy.

The course of symptoms is typically relapsing and remitting, which means that they flare up and then ease off for extended periods during remission.

One or more enlarged lymph nodes are the most typical initial sign. Under your skin, swollen lymph nodes feel like firm lumps. It could take years for the lymph node swelling to become diagnosed.

Numerous other conditions besides cancer can also cause swollen lymph nodes.

Symptoms of spleen or bone marrow involvement

Your spleen or bone marrow may be affected by follicular lymphoma. About 70% of individuals have bone marrow involvement. You can experience low blood cell counts and splenic enlargement when this occurs.

Symptoms of low blood cell counts include:
  • easy bruising or bleeding
  • bleeding gums
  • fatigue
  • frequent infections
  • dizziness
  • weakness
  • lightheadedness
  • severe infections
  • shortness of breath
  • fast breathing rate
  • Your skin may have tiny, purplish-red lesions known as petechiae.

Symptoms of follicular lymphoma B

B symptoms are seen in 20% of patients with follicular lymphoma. The prognosis and cancer stage are predicted in part by these symptoms. B symptoms consist of:
  • night sweats
  • fever
  • more than 10% of your body weight should be lost in six months.
Up to 30–40% of patients with follicular lymphoma progress to diffuse large B-cell lymphoma (DLBCL), a more severe kind of malignancy. DLBCL patients are more likely to experience B symptoms.

Where in the body does follicular lymphoma typically start?

Your lymph nodes are where follicular lymphoma typically begins. The lymph nodes that are most frequently affected are those in your:
  • neck
  • groin
  • armpits
  • thighs
Additionally, your belly may have swollen lymph nodes, though these are normally not palpable.

Primary gastrointestinal lymphoma is a form of follicular lymphoma that typically begins in the first segment of the small intestine. In other places, it usually has a better prognosis than follicular lymphoma.

Although follicular lymphoma in children is uncommon, when it does occur, it usually starts in the tonsils and head and neck lymph nodes. A lot of researchers classify paediatric follicular carcinoma as a different kind of lymphoma.

What are the treatment options for follicular lymphoma?

After treatment, follicular lymphoma frequently recurs, albeit it might benefit from further care.

The following are the primary options for treating follicular lymphoma:
  • radiation therapy
  • chemotherapy
  • targeted therapy
  • stem cell transplant
  • immune treatments like CAR T-cell therapy
  • Watchful waiting, or delaying starting treatment until after the malignancy has changed

What’s the outlook for someone with follicular lymphoma?

While the prognosis for follicular lymphoma is frequently favourable, the disease can progress very differently in each individual. People typically survive for more than 20 years following their diagnosis.

While some people may never experience any symptoms, others may experience serious side effects that require ongoing care.

When reporting survival statistics, doctors frequently utilise 5-year relative survival rates. The number of cancer patients who are still alive after five years, relative to those who do not have the disease, is known as the 5-year relative survival rate.

From 2012 to 2018, the following were the 5-year relative survival rates for follicular lymphoma in the US:

Stage5-year relative survival rate
All stages90%

Prognostic factors

To forecast how well follicular lymphoma will respond to treatment, medical professionals frequently utilise the Follicular Lymphoma International Prognostic Index. This index takes into account the following elements:

Prognostic factorGoodPoor
Age60 years or underover 60 years
Stage1 or 23 or 4
Hemoglobinover 120 grams per liter (g/L)under 120 g/L
Lactate dehydrogenase levelsnormallyelevated
Number of affected lymph nodes4 or fewermore than 4

The number of risk factors you have determines your likelihood of dying from cancer:

Risk groupNumber of risk factors2-year survival rate
Low risk0 or 198%
Medium risk294%
High risk3 or more87%


What is early-stage lymphoma?

One lymph node, one lymphoid organ (like the thymus), or one portion of a single organ outside the lymphatic system can all have cancer.

How treatable is follicular lymphoma?

Although follicular lymphoma is typically incurable, it can be managed to improve quality of life. Remission, or a marked reduction in the amount of lymphoma, is the goal of treatment. Those without symptoms might not require medical attention for a very long period, if at all.


A slow-growing malignancy that starts in your lymphatic system is called follicular lymphoma. Swelling in a lymph node is frequently the initial sign.

Although each case of follicular lymphoma is different, the prognosis is often better than that of most other lymphomas.

Follicle cell lymphoma is rarely curable, according to medical authorities, because the cancer frequently returns after treatment. Chemotherapy, radiation therapy, and other therapies, however, might lessen your symptoms and even add decades to your life.

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