A 55 year-old man comes to your office because he is concerned about swollen lymph nodes in his axilla and inguinal regions. He reports, ‘they (swollen lymph nodes) don’t bother me but I am concerned about fever, weight loss and drenching night sweats’. Physical examination reveals painless cervical, axillary, inguinal lymphadenopathy and hepatosplenomegaly. Laboratory tests show elevated LDH levels. An excisional lymph node biopsy revealed back-to-back follicles of the same size, composed of small cells or large cells. Later flow cytometry and genetic tests confirmed the diagnosis as follicular lymphoma.
