What Is The Diagnosis and Staging of Follicular Lymphoma?

Follicular lymphoma is classified as a Non-Hodgkin's Lymphoma. It is an indolent (slow-growing) cancer that affects B-Cell Lymphocytes. Like most lymphomas, it usually begins in the lymph nodes; it can spread into the blood and bone marrow, as well as the internal organs. The liver and spleen may also be affected.

Follicular lymphoma accounts for a high percentage of B-Cell Lymphomas. Approximately 20-30% of cases of NHL are diagnosed as Follicular Lymphoma. Most of these diagnoses occur in adults over the age of 60, with an equal occurrence in males and females.

Diagnosis and Staging of Follicular Lymphoma

Most patients with Follicular Lymphoma will have little to no symptoms until the later stages of the disease because it is indolent. Symptoms include painless, swollen lymph nodes in the neck, armpit, or groin, fever, fatigue, night sweats, and unexplained weight loss.

If the doctor suspects cancer, he will conduct a biopsy on an affected lymph node. A chest X-ray, CT or PET scan, or other diagnostic tests may also be ordered to help stage the disease.

Stage I: Marked by the involvement of only one group of lymph nodes or one section of organ tissue.

Stage II: The disease has spread to two lymph groups on the same side of the diaphragm, or to a lymph group and nearby organ.

Stage III: The disease includes lymph nodes on both sides of the diaphragm.

Stage IV: The disease involves multiple internal organs, including the liver, bone marrow, and blood.

Follicular lymphoma is also divided into three grades, based on the ratio of large to small B-cells affected:

Grade 1: Cancer is made up of all small cells.

Grade 2: Cancer is a mixture of large and small cells.

Grade 3: Cancer affects mostly large cells; generally more aggressive.

Even though most patients are diagnosed in later stages of the disease, prognosis is still good. There is a 70% chance of survival at the ten-year mark.

Treatment of Follicular Lymphoma

Treatments vary based on the stage of the disease. Luckily, follicular lymphoma is very sensitive to both radiation and chemotherapy, so treatment is highly effective. Methods include:

  • Radiation treatment, especially in earlier stages of the disease (Stage I and II).
  • Chemotherapy regimens, like the CHOP protocol (cyclophosphamide, doxorubicin, vincristine, and prednisone).
  • Monoclonal antibodies such as Rituximab, Bexxar, or Zevalin.
  • Combined regimens, especially the R-VCP protocol. This uses the monoclonal antibody rituximab, along with chemotherapy agents cyclophosphamide and vincristine. Prednisone, a steroid, is used to help prevent internal swelling and keep organs healthy while on this regimen.
  • Stem Cell Transplant is used in patients with relapsed lymphoma.
  • The wait and watch method is used for patients who are diagnosed but aren't presenting symptoms. This method has the same survival rate as patients who are treated before symptoms present. Once a patient shows common symptoms of the disease, treatment is administered.

Source: Indolent Follicular Lymphoma fact sheet from the Lymphoma Research Foundation
Photo: Pexels

More Articles

More Articles

There are two types of cancer: benign and malignant. Benign cancers are the kind that don't spread and don't threaten one's life. Malignant...

Hodgkin's Disease—also referred to as Hodgkin's Lymphoma, these are the exact same diseases, just...

The Follicular Lymphoma International Prognostic Index, or FLIPI, is a standardized guide to help oncological diagnosticians accurately calculate...

Diffuse large B cell lymphoma prognosis is contingent upon several factors, and can be determined by using a well-...

The term 'metastatic lymphoma' does not refer to a diagnosis. Unlike many of the subtypes of lymphoma we have...

Diagnosing lymphoma is one of the more difficult diagnoses to make in cancer medicine, and contrary to perception, diagnosing lymphoma is not made...

Burkitt's lymphoma is an aggressive B-cell lymphoma that is common in children...

Treatment for Non-Hodgkin’s Lymphomas (NHL) differs from patient to patient. The regimen used depends on the type of...

Large Cell Lymphoma (LCL) is typically an aggressive (fast growing) cancer of either the B cell or T cell type. They are one of the most common...

Aggressive Non-Hodgkin’s Lymphomas (NHLs) are fast growing cancers (as opposed to indolent cancers). They involve...

Lymphoma is not difficult to diagnose once a patient and doctor begin to look for signs of cancer. However, Lymphoma–especially...

A lymphoma prognosis varies greatly depending on the type of lymphoma. There are more than 35 types of lymphoma, including 5 types of...

The lymphatic system, or lymph system, defends the body from foreign invasion by disease causing agents such as viruses, bacteria, or fungi. The...

Lymphoma is a cancer of the lymphatic system, causing B-cell or...

With any cancer, early detection is the best predictor of long-term survival, and lymphoma is no exception. The trickiest thing about lymphoma is...