FROM ASYMPTOMATIC ADENOMEGALY TO FOLLICULAR LYMPHOMA DIAGNOSIS

Introduction and Objective: Follicular Lymphoma (FL) is the second most common subtype of non-Hodgkins Lymphoma (NHL) and the most common indolent NHL. It often presents painless adenomegaly, slowly progressive. Systemic symptoms, such as fever and night sweats, and signs associated with dysfunction of the bone marrow, such as cytopenias, are uncommon in the beginning. Methods: The authors present a case report of a 34-year-old female patient followed regularly by the Family Physician (FP), after collection of medical, personal and familiar antecedents and diagnostic tools’ results assessment. Results and Conclusions: The patient has history of depression and tobacco abuse (10 cigarettes/day over 16 years) and her usual medication is oral contraceptive and lorazepam. His mother died due to unspecified lymphoma. In May 2013 she noticed left inguinal tumefactions, painless and no other symptoms since then. In May 2015, after cervical cancer screening, the FP found three elastic tumefactions, the bigger one 3cm diameter, in the left inguinal region. Because of high level of suspicion, a clinical research was initiated with some diagnostic tools. After that it was necessary to perform an excisional biopsy of one lymphadenopathy. The histological result was FL grade 1-2. Subsequently she was referred to an oncology center, where she is currently on chemotherapy treatment. The presumptive diagnosis, considering the family history and adenopathy’s characteristics assessed opportunistically, led to a timely diagnosis and a better prognosis. The biopsychosocial approach has been very important, considering the disease and chemotherapy impact on quality of life.