Spontaneous Metabolic Regression in High‐Burden Follicular Lymphoma: A Case Report

TL;DR

A 64-year-old man with high-burden follicular lymphoma experienced a significant spontaneous metabolic regression without treatment over six months.

Contribution

This case report documents a rare instance of spontaneous metabolic regression in high-burden follicular lymphoma.

Findings

The patient showed marked metabolic response in nodal, splenic, and serosal areas on [18F]FDG PET/CT.

Symptoms resolved and laboratory parameters improved without therapy over six months.

The case underscores the biological variability and potential for spontaneous regression in follicular lymphoma.

Abstract

Follicular lymphoma (FL) is an indolent but incurable B‐cell malignancy, typically requiring therapy in patients with high tumor burden. Although spontaneous regression has been described, its frequency and durability are uncertain and require longitudinal follow‐up. We report a 64‐year‐old man with high‐burden FL fulfilling GELF criteria who deferred treatment and subsequently demonstrated a marked spontaneous metabolic response on a follow‐up [18F]FDG PET/CT over a 6‐month follow‐up period. The metabolic response encompassed nodal, splenic, and serosal involvement, accompanied by resolution of symptoms and improvement in laboratory parameters. This case highlights the biological heterogeneity of FL and emphasizes the importance of individualized management and ongoing surveillance.

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