Follicular lymphoma is an indolent lymphoma. The cell of origin is thought to be the follicular center B cell. While it can be cured by local therapy in the early stages, it is more usually diagnosed in an advanced stage, when cure is exceedingly rare. It is generally quite responsive to chemotherapy but almost always relapses. The clinical course is commonly marked by a series of chemotherapy-induced remissions followed by relapses, the interval between these decreasing over time. The end-stage of the disease may be characterized by insuperable resistance to chemotherapy or by transformation to an aggressive large B-cell phenotype. Despite the very low cure rate, many patients nonetheless survive more than a decade due to the indolent nature of the disease.
Histologically, it is characterized by a follicular pattern in the lymph node. The appearance can be similar to that of the non-malignant follicular hyperplasia. Light-chain restriction can be useful in suggesting the clonality of the tumor, which distinguishes it from benign hyperplasia.
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