What Is Follicular Hyperplasia?

Follicular hyperplasia is a benign white blood cell disorder where the lymph nodes enlarge because of an increased number of germinal centers, areas where cells mature and differentiate to supply the lymphatic system with new white blood cells. There can be a number of different causes, and a doctor can provide treatment, if necessary, after evaluating the patient and learning more about the condition. It is important to be aware that follicular hyperplasia is not a cancer like Hodgkin's lymphoma, but a doctor may need to do some cancer testing to rule it out, just in case.

Patients typically develop this condition in response to infection or inflammation. The lymph nodes swell and enlarge not just because they collect more detritus when the immune system kicks into action, but because the germinal centers may proliferate to meet the needs of the immune system. If a doctor takes a biopsy, she will see an assortment of many types of lymph cells, along with more germinal centers than usual, including deep within the lymph node.

The presence of a mixture of lymph cells is a sign of follicular hyperplasia, as opposed to cancerous conditions. In a cancerous lymph node, the pathologist would expect to see only one kind of cell, the result of a cancerous cell going rogue and replicating out of control. A blend of many cell types is suggestive of benign growth, and it will not spread to other lymph nodes or neighboring tissue.

Cases of follicular hyperplasia may be associated with lymphedema, where the extremities swell with fluid. This happens when the lymphatic system cannot clear fluid fast enough and it starts to pool, especially in the feet and legs. A doctor may recommend compression garments to prevent buildup and push the existing fluid slowly back into circulation so the body can eliminate it. Other treatments may include dietary changes and medications.

When a doctor feels a swollen lymph node, he will take note of all other systems and may request some medical testing to learn more about the cause. With follicular hyperplasia, the doctor wants to make sure that any malignancies are ruled out, because the treatment will differ depending on the cause. Diagnostic testing will reduce the risk of making bad treatment recommendations that might result in failure to treat a malignancy in the early stages, when it would still be manageable and the patient would have a good prognosis.