Follicular lymphoma is a common type of non-Hodgkin lymphoma.
In most cases, follicular lymphoma shows a painless, slow and progressive adenopathy . Systemic symptoms like fever, night sweats and weight loss is not seen at presentation most of the time but it can be seen in later stages of the disease.
Progression to an intermediate-grade or high-grade lymphoma is considered as soon as a patient develops any systemic symptoms.
Another set of symptoms which may occur in the later stages of the condition are those depicting dysfunction of the bone marrow such as anemia, leukopenia and thrombocytopenia.
Tests and procedures used to diagnose follicular lymphoma include :
Indolent lymphomas that don't cause signs and symptoms may not require treatment for years .
When signs and symptoms are fully developed, treatment may include any of the following:
The median survival is placed at 10 years with a wide range which could be as little as one year in some and more than 20 years in others . The overall 5 year survival rate for the condition is 72 to 77%.
There is a definite cause for follicular lymphoma but several etiologic factors have been indicated .
In the United States, the fifth most frequently diagnosed malignancy is non-Hodgkin lymphoma. Over 50,000 cases are diagnosed each year and out of these, 15 to 20% are follicular lymphomas. No sex preponderance is seen in the US .
Internationally, the age rates of non-Hodgkin lymphoma are higher in more developed countries. The incidence of follicular lymphomas increases with age and so it is rarely seen in children.
The median age at diagnosis is 60 to 65 years. Variations in racial incidence have been noted around the world. The incidence of follicular lymphoma is low in China and Japan but higher in people of Jewish descent. In the United States, the condition is seen more in blacks than in whites.
In patients with follicular lymphoma, the most common acquired non-random chromosomal translocation is t(14;18) . It is seen in more than 80% of all cases.
With this chromosomal translocation, the bcl2 protooncogen is brought under the transcriptional influence of the immunoglobulin heavy-chain gene and this leads to overexpression of a functionally normal bcl-2 protein.
Overexpression of bcl-2 confers a survival advantage to the cancer cells by preventing apoptosis. Although the exact mechanism and course of action of bcl-2 is not quite clear, its interaction with other homologues is believed to have an influence on the possibility of a cell undergoing apoptosis.
The t(14;18) product is detected by polymerase chain reaction (PCR) and is used frequently in the diagnosis and follow-up of patients who have follicular lymphomas.
There is no prevention for this condition.
Follicular lymphoma is a type of B-cell lymphoma . It is one of the most common forms of non-Hodgkin lymphoma. The disorder is characterized by tumor cells which look circular or clump-like when viewed under the microscope. The irregular shaped follicles distort the usual appearance and structure of a lymph node. In people with follicular lymphoma, the CD20 protein is visible on the surface of the cancerous cells. Some treatment models target proteins synthesis.
Most patients with follicular lymphoma are diagnosed at its advanced stage and the bone marrow is involved most of the time at diagnosis.
Follicular lymphoma has four stages :
Follicular lymphoma is categorized into grades further depending on the number of centroblasts per high-power field (hpf), as follows:
In follicular lymphoma, tumors develop from lymphocytes which are of basically white blood cell. It is mostly seen in people aged 50 and above are did and the average age at diagnosis is 60 years. Most people with follicular lymphoma are aged over 65 and the condition is seen more in men than in women.
The causes of follicular lymphoma are unclear but it does not arise as a result of to infection. The condition is therefore not contagious.
Treatment for follicular lymphoma depends on the individual situation. If it is confined to one area, local radiotherapy is the treatment given. When follicular lymphoma is at an early stage and/or the person is symptom-free, the waiting approach is usually adoptedD. This involves close monitoring by the specialist, with active treatments such as chemotherapy being postponed till symptoms become visible.