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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0043-1777042
Case Report with Review of Literature

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

Anthony Chibueze Nlemadim 
1   Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
,
Theophilus Ipeh Ugbem
2   Department of Pathology, University of Calabar, Calabar, Nigeria
,
Gabriel Unimke Udie
3   Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria
,
Godwin Cletus Omini
4   Department of Haematology, University of Calabar Teaching Hospital, Calabar, Nigeria
,
Eghomwanre Davis Izekor
1   Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
,
Olufunke Folaranmi Adedokun
1   Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
,
Ekaete Joseph Asuquo
1   Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
,
Martin Madu Meremikwu
1   Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
,
Friday Akwagiobe Odey
1   Department of Paediatrics, University of Calabar Teaching Hospital, Calabar, Nigeria
› Author Affiliations Financial Support, Grant, and Sponsorship None.
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Abstract

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.

Keywords

pediatric - follicular - advanced - lymphoma - resource-poor

Statement

This manuscript has been read and approved by all the authors who met the requirements for authorship. Each author believes that the manuscript represents an honest work.


Ethical Approval

Permission to conduct this study was obtained from the University of Calabar Teaching Hospital Health Research and Ethics Committee (UCTH/HREC/33/Vol.III/052).


Consent for Publication

Informed written consent was obtained from the patient's parents for this case report publication.


Patient Consent

Consent is given.


Authors' Contributions

1. A.C.N.: conceptualized the study and designed it; defined the intellectual content; performed literature search; acquired data from the patient case file; investigations analysis and interpretation; drafted, edited, and revised the manuscript; and gave final approval for publication.


2. T.I.U.: designed the study; defined some intellectual content; performed literature search; investigations analysis and interpretation; edited and revised the manuscript; and gave final approval for publication.


3. G.U.U.: designed the study; defined some intellectual content; investigations analysis and interpretation; edited and revised the manuscript; and gave final approval for publication.


4. G.C.O.: conceptualized the study and designed it; defined some intellectual content; performed literature search; investigations analysis and interpretation; edited and revised the manuscript; and gave final approval for publication.


5. E.D.I.: conceptualized the study; performed literature search; acquired data from the patient case file; investigations analysis; edited and revised the manuscript; and gave final approval for publication.


6. O.F.A.: conceptualized the study; performed literature search; acquired data from the patient case file; investigations analysis; edited and revised the manuscript; and gave final approval for publication.


7. E.J.A.: conceptualized the study; performed literature search; acquired data from the patient case file; investigations analysis; edited and revised the manuscript; and gave final approval for publication.


8. M.M.M.: designed the study; defined the intellectual content; investigations interpretation; edited and revised the manuscript; and gave final approval for publication.


9. F.A.O.: designed the study; defined the intellectual content; investigations interpretation; edited and revised the manuscript; and gave final approval for publication.




Publication History

Article published online:
19 December 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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