Signs of Follicular Lymphoma: A Complete Guide to Symptoms, Diagnosis, and Treatment

Follicular lymphoma is the second most common form of non-Hodgkin lymphoma, representing about 20% of cases worldwide, according to the Leukemia & Lymphoma Society (LLS). It often develops slowly, making it difficult to detect in early stages. Recognizing signs of follicular lymphoma is crucial, since early evaluation can lead to better management and monitoring. While the disease is generally indolent (slow-growing), it requires medical attention to prevent progression.

Signs of Follicular Lymphoma

Follicular lymphoma affects the lymphatic system, which plays a central role in immunity. Because the disease develops gradually, symptoms may be subtle or mistaken for other conditions. Common signs include:

Enlarged lymph nodes – Usually painless, found in the neck, armpits, or groin.
Persistent fatigue – A frequent symptom due to the body’s immune response.
Unexplained fever or night sweats – Known as “B symptoms,” which sometimes indicate more advanced disease.
Unintentional weight loss – Often accompanies other systemic signs.
Fullness or discomfort in the abdomen – Caused by enlarged lymph nodes or spleen pressing against organs.

When to Seek Medical Evaluation

Because symptoms can mimic infections or other illnesses, many people delay evaluation. However, medical experts recommend seeking attention if:

Lymph nodes remain enlarged for more than two weeks.
Fatigue, fever, or night sweats persist without a clear cause.
Weight loss occurs unexpectedly.
Abdominal pain or swelling interferes with daily activities.

How Follicular Lymphoma Is Diagnosed

Doctors rely on several tests to confirm or rule out follicular lymphoma:

Physical exam – Checking for enlarged lymph nodes, spleen, or liver.
Blood tests – To evaluate overall health and look for abnormal markers.
Lymph node biopsy – A tissue sample is examined under a microscope for lymphoma cells.
Imaging scans (CT, PET) – Used to determine the extent of disease.
Bone marrow biopsy – Sometimes performed to check spread within the bone marrow.

Risk Factors and Who Is Affected

Certain factors may increase the likelihood of developing follicular lymphoma:

Age – Most cases are diagnosed in adults over 60.
Gender – Slightly more common in men than women.
Family history – Having a close relative with lymphoma may raise risk.
Weakened immune system – From autoimmune disease, organ transplant, or chronic infections.

Living With Follicular Lymphoma

Because follicular lymphoma is slow-growing, doctors often recommend “watchful waiting” if symptoms are mild. Treatment options are considered when the disease begins to cause complications and may include:

Targeted therapies (e.g., monoclonal antibodies)
Chemotherapy
Radiation therapy (for localized disease)
Clinical trials exploring new treatments

Conclusion

Recognizing the signs of follicular lymphoma is the first step toward proper diagnosis and management. While symptoms may appear mild at first—such as painless swollen lymph nodes or fatigue—early medical evaluation ensures the best long-term outlook. Anyone experiencing persistent or unexplained symptoms should seek guidance from a healthcare professional.