Causes and symptoms of follicular lymphoma

• Some people are slightly more likely to develop follicular lymphoma than others, but we don’t know why.
• The most common symptom of follicular lymphoma is a lump, or lumps, caused by swollen lymph nodes (glands).
• You may also have B symptoms – these are night sweats, fever, and unexplained weight loss.

Although doctors can’t explain why, some people are slightly more likely to develop a low grade non-Hodgkin lymphoma like follicular lymphoma than others.

When you are diagnosed, your hospital team might talk to you about your risk score, which is based on your risk factors. These include things like:

• Age: Follicular lymphoma is more common in people over 50, but people of any age can develop it. It is rare in children.
• Sex: Men are slightly more likely than women to get follicular lymphoma.
• Family history: You are slightly more likely to develop follicular lymphoma if your parent or sibling has any type of lymphoma, but the risk is still very small.
• Previous cancers: If you’ve had any kind of cancer or treatment for cancer previously, you have a slightly higher risk of developing follicular lymphoma.
• Immune system deficiencies: If you have a weakened immune system, or you take immunosuppressant drugs, you might be more likely to get lymphoma. People with auto-immune diseases such as coeliac disease or rheumatoid arthritis also have a higher chance of developing a non-Hodgkin lymphoma.
• Epstein Barr virus (EBV): People who have had EBV in the past may be more at risk of developing follicular lymphoma, but this is rare and the chances are still very low.

Lots of people with follicular lymphoma don’t have any risk factors, and having one or more risk factors doesn’t mean you will develop any type of non-Hodgkin lymphoma.

It’s also important to know that there is nothing you could have done to stop yourself from getting follicular lymphoma. You can’t catch it, and it can’t be passed on to anyone else.

Follicular lymphoma can cause a range of symptoms, but some people won’t notice any at all. We talk about some of the symptoms you might experience below.

Remember, everybody is different and you might have different symptoms than someone else you know. If something just doesn’t feel right with your body, or you have a new unexplained symptom you’re worried about, speak to your hospital team.

The most common symptom of follicular lymphoma is lumps caused by swollen lymph nodes (also known as swollen lymph glands). These are usually painless. They’re caused by abnormal B lymphocyte cells (a type of white blood cell) clustering together in different places throughout your lymphatic system.

You might be able to see or feel a lump in your armpit, neck or groin (where the top of your leg meets your body), but some people won’t have any obvious lumps. Although the lumps themselves will probably be painless, you might still experience some irritation based on where they are – for example, a swelling in your groin may cause skin chafing when you walk or exercise.

Abnormal B lymphocytes can also gather deeper in your body, where it’s not possible to see or feel any swelling. However, lumps in these areas can cause other symptoms, including:

• pain in your abdomen (stomach area) due to a lump pressing against an organ such as your liver, gut or kidneys
• pain in your chest due to a lump blocking your lungs. You may also feel breathless, and have a persistent cough
• bone pain, caused by abnormal B lymphocytes in your bone marrow (the spongy material inside your bones where blood cells are made.)

Most people with follicular lymphoma will have one or more lumps somewhere in their body, but not everyone will.

Fatigue can be another symptom of follicular lymphoma. This is a more intense form of feeling tired, and can come on without warning. Unlike usual tiredness, fatigue isn’t always helped by getting more sleep or rest.

Our information about fatigue has tips which might help.

As well as having lumps and fatigue, some people with follicular lymphoma may also experience B symptoms. These are:

• night sweats, which soak your nightclothes and bedding
• fever (a temperature of 38 degrees or higher without any other signs of infection)
• unexplained weight loss.

Having B symptoms (or not) can help your doctor understand how the follicular lymphoma is affecting you and how advanced the disease is. This then helps them to stage the disease and decide on the best type of treatment to recommend.

Read more about staging.

Because follicular lymphoma affects your white blood cells, you may be more at risk of developing infections. If you notice that you’re feeling unwell more often than usual, or you can’t seem to shake off a cold, this could also be a sign of lymphoma.

Infections can be life threatening for people with blood cancer, so make sure you know the signs and symptoms of an infection and learn what to do if you have any.