Follicular lymphoma

Last revised by Ian Teng on 17 Oct 2022

Follicular lymphoma is the most common subtype of indolent non-Hodgkin lymphoma (NHL), second most common overall, behind diffuse large B-cell lymphoma 6

Estimated to account for ~45% of all NHL cases 1. Higher rates in North America and Europe 4

Nodal effacement by closely packed follicles containing small cleaved cells without nucleoli (centrocytes) and larger non-cleaved cells with moderate cytoplasm, open chromatin and multiple nucleoli (centroblasts).

Follicular lymphoma is categorized into grades according to the number of centroblasts per high-power fields (HPF) as follows5:

  • grade 1: 0-5 centroblasts per HPF
  • grade 2: 6-15 centroblasts per HPF
  • grade 3: >15 centroblasts per HPF
  • CD10: positive
  • CD5: negative
  • CD20: positive

Translocation t(14;18) is found in the majority of patients with follicular lymphoma. 

It is often indolent yet incurable with a high prevalence of residual mass post-treatment 2.

Transformation to a more aggressive type of NHL.

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Cases and figures

  •  Case 1
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  • Case 2: right hilum
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  • Case 3: mesenteric lymphadenopathy
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  • Case 4: follicular lymphomatosis
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