Advanced Pediatric-Type Follicular Lymphoma, Consequences of a Late Presentation in a Resource-Poor Setting: Case Report and Literature Review

Pediatric-type follicular lymphoma (PFL) is a rare, nonaggressive, slow-growing (indolent), non-Hodgkin lymphoma that is typically seen in males as a localized disease with excellent outcomes. It is largely different from follicular lymphoma (FL). Few published studies on PFL are case series in deve...

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Main Authors: Anthony Chibueze Nlemadim, Theophilus Ipeh Ugbem, Gabriel Unimke Udie, Godwin Cletus Omini, Eghomwanre Davis Izekor, Olufunke Folaranmi Adedokun, Ekaete Joseph Asuquo, Martin Madu Meremikwu, Friday Akwagiobe Odey
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd.
Series:Indian Journal of Medical and Paediatric Oncology
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1777042
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author Anthony Chibueze Nlemadim
Theophilus Ipeh Ugbem
Gabriel Unimke Udie
Godwin Cletus Omini
Eghomwanre Davis Izekor
Olufunke Folaranmi Adedokun
Ekaete Joseph Asuquo
Martin Madu Meremikwu
Friday Akwagiobe Odey
author_facet Anthony Chibueze Nlemadim
Theophilus Ipeh Ugbem
Gabriel Unimke Udie
Godwin Cletus Omini
Eghomwanre Davis Izekor
Olufunke Folaranmi Adedokun
Ekaete Joseph Asuquo
Martin Madu Meremikwu
Friday Akwagiobe Odey
author_sort Anthony Chibueze Nlemadim
collection DOAJ
description Pediatric-type follicular lymphoma (PFL) is a rare, nonaggressive, slow-growing (indolent), non-Hodgkin lymphoma that is typically seen in males as a localized disease with excellent outcomes. It is largely different from follicular lymphoma (FL). Few published studies on PFL are case series in developed nations. We report on a patient with advanced PFL, a 14-year-old female with 5-year history of neck swellings, abdominal distension for a month, and pericardial effusion, among others. The swellings waxed and waned; and involved all the peripheral lymph nodes. Tuberculosis (TB) GeneXpert and human immunodeficiency virus (HIV) screening were negative. She received anti-TB drugs prior to presentation in our hospital where nodal histopathology showed effaced architecture with diffuse follicles and abundant blastoid cells as well as negative CD5 and BCL2, and positive CD10 and CD20. Diagnosis of PFL (stage 3) was made. She completed six courses of cyclophosphamide, doxorubicin, vincristine, and prednisolone and is well 9 months after therapy. The PFL usually presents with stage 1 or 2 disease unlike in the index female case that was also complicated by effusion and ascites due to late presentation. It responded to chemotherapy and has not reoccurred; in contrast to classic FL and reactive follicular hyperplasia (RFH) which should be differentiated from PFL. Although RFH can be caused by TB or HIV, they are not causes of malignant lymphadenopathy. Physicians should be aware of PFL which may present in high clinical stages, but still retain its good prognosis, for the purposes of counseling.
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series Indian Journal of Medical and Paediatric Oncology
spelling doaj-art-3a01a71a66af4937a5015dca01ce764c2025-08-20T02:32:44ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Medical and Paediatric Oncology0971-58510975-212910.1055/s-0043-1777042Advanced Pediatric-Type Follicular Lymphoma, Consequences of a Late Presentation in a Resource-Poor Setting: Case Report and Literature ReviewAnthony Chibueze Nlemadim0https://orcid.org/0000-0003-0095-8975Theophilus Ipeh Ugbem1Gabriel Unimke Udie2Godwin Cletus Omini3Eghomwanre Davis Izekor4Olufunke Folaranmi Adedokun5Ekaete Joseph Asuquo6Martin Madu Meremikwu7Friday Akwagiobe Odey8Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, NigeriaDepartment of Pathology, University of Calabar, Calabar, NigeriaDepartment of Surgery, University of Calabar Teaching Hospital, Calabar, NigeriaDepartment of Haematology, University of Calabar Teaching Hospital, Calabar, NigeriaDepartment of Paediatrics, University of Calabar Teaching Hospital, Calabar, NigeriaDepartment of Paediatrics, University of Calabar Teaching Hospital, Calabar, NigeriaDepartment of Paediatrics, University of Calabar Teaching Hospital, Calabar, NigeriaDepartment of Paediatrics, University of Calabar Teaching Hospital, Calabar, NigeriaDepartment of Paediatrics, University of Calabar Teaching Hospital, Calabar, NigeriaPediatric-type follicular lymphoma (PFL) is a rare, nonaggressive, slow-growing (indolent), non-Hodgkin lymphoma that is typically seen in males as a localized disease with excellent outcomes. It is largely different from follicular lymphoma (FL). Few published studies on PFL are case series in developed nations. We report on a patient with advanced PFL, a 14-year-old female with 5-year history of neck swellings, abdominal distension for a month, and pericardial effusion, among others. The swellings waxed and waned; and involved all the peripheral lymph nodes. Tuberculosis (TB) GeneXpert and human immunodeficiency virus (HIV) screening were negative. She received anti-TB drugs prior to presentation in our hospital where nodal histopathology showed effaced architecture with diffuse follicles and abundant blastoid cells as well as negative CD5 and BCL2, and positive CD10 and CD20. Diagnosis of PFL (stage 3) was made. She completed six courses of cyclophosphamide, doxorubicin, vincristine, and prednisolone and is well 9 months after therapy. The PFL usually presents with stage 1 or 2 disease unlike in the index female case that was also complicated by effusion and ascites due to late presentation. It responded to chemotherapy and has not reoccurred; in contrast to classic FL and reactive follicular hyperplasia (RFH) which should be differentiated from PFL. Although RFH can be caused by TB or HIV, they are not causes of malignant lymphadenopathy. Physicians should be aware of PFL which may present in high clinical stages, but still retain its good prognosis, for the purposes of counseling.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1777042pediatricfollicularadvancedlymphomaresource-poor
spellingShingle Anthony Chibueze Nlemadim
Theophilus Ipeh Ugbem
Gabriel Unimke Udie
Godwin Cletus Omini
Eghomwanre Davis Izekor
Olufunke Folaranmi Adedokun
Ekaete Joseph Asuquo
Martin Madu Meremikwu
Friday Akwagiobe Odey
Advanced Pediatric-Type Follicular Lymphoma, Consequences of a Late Presentation in a Resource-Poor Setting: Case Report and Literature Review
Indian Journal of Medical and Paediatric Oncology
pediatric
follicular
advanced
lymphoma
resource-poor
title Advanced Pediatric-Type Follicular Lymphoma, Consequences of a Late Presentation in a Resource-Poor Setting: Case Report and Literature Review
title_full Advanced Pediatric-Type Follicular Lymphoma, Consequences of a Late Presentation in a Resource-Poor Setting: Case Report and Literature Review
title_fullStr Advanced Pediatric-Type Follicular Lymphoma, Consequences of a Late Presentation in a Resource-Poor Setting: Case Report and Literature Review
title_full_unstemmed Advanced Pediatric-Type Follicular Lymphoma, Consequences of a Late Presentation in a Resource-Poor Setting: Case Report and Literature Review
title_short Advanced Pediatric-Type Follicular Lymphoma, Consequences of a Late Presentation in a Resource-Poor Setting: Case Report and Literature Review
title_sort advanced pediatric type follicular lymphoma consequences of a late presentation in a resource poor setting case report and literature review
topic pediatric
follicular
advanced
lymphoma
resource-poor
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1777042
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