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Follicular lymphoma (FL) is a common type of non-Hodgkin lymphoma, specifically an indolent B-cell lymphoproliferative disorder originating from transformed follicular center B cells. It accounts for approximately 20-30% of all non-Hodgkin lymphomas and typically grows slowly over many years. FL usually arises due to a genetic abnormality involving a translocation between chromosomes 14 and 18 [t(14;18)], leading to overexpression of the anti-apoptotic protein BCL2, which helps the malignant B cells survive longer than normal. Histologically, FL is characterized by a proliferation of small to medium-sized B cells, forming follicle-like structures in lymph nodes and other lymphoid tissues.

Patients with follicular lymphoma may present with painless swelling of lymph nodes in the neck, armpits, or groin. Other symptoms can include fatigue, unexplained weight loss, night sweats, and sometimes fever. The disease is often discovered incidentally during evaluations for other conditions due to its slow progression. While FL is generally considered incurable, many patients live for years with manageable symptoms as it behaves like a chronic disease.

Treatment options include watchful waiting for asymptomatic cases, immunotherapy, chemotherapy, targeted therapies, and sometimes stem cell transplantation depending on disease severity and progression.