Follicular lymphoma vs Mantle cell lymphoma
How to tell Follicular lymphoma and Mantle cell lymphoma apart when a board question makes them look alike.
Follicular is BCL2/t(14;18) indolent follicle disease; mantle is cyclin D1/t(11;14) aggressive mantle-zone disease.
Side by side
Follicular lymphoma is an indolent germinal-center B-cell lymphoma with painless generalized lymphadenopathy, follicular architecture, t(14;18), and BCL2 overexpression.
Mantle cell lymphoma is an aggressive mature B-cell lymphoma with older male predominance, mantle-zone expansion, t(11;14), cyclin D1 overexpression, and possible GI polyposis.
BCL2 overexpression prevents apoptosis, allowing germinal-center B cells to accumulate in follicles.
Cyclin D1 overexpression drives cell-cycle progression in mantle-zone B cells.
CD20, CD10, BCL6, t(14;18), and BCL2 overexpression support follicular lymphoma.
CD20, CD5, cyclin D1, SOX11, and t(11;14) support mantle cell lymphoma.
The trap
Both are mature B-cell lymphomas, so translocation and marker set prevent mixing them up.
Watch it explained
The repair move
For mature B-cell lymphoma, match the translocation to the protein: BCL2 for follicular, cyclin D1 for mantle.
Try a free question
CoreAn older adult has painless generalized lymphadenopathy. Lymph node biopsy shows follicular architecture with CD10-positive B cells and t(14;18) causing BCL2 overexpression. Which diagnosis is most likely?
Show answer and explanation
Answer: A. Follicular lymphoma. t(14;18) with BCL2 overexpression and follicular architecture points to follicular lymphoma.
Why the other choices are tempting
- B. Mantle cell lymphoma has t(11;14) with cyclin D1 overexpression.
- C. Burkitt lymphoma has MYC t(8;14) and starry-sky histology.
- D. CLL/SLL has mature small lymphocytes and smudge cells.
- E. Hodgkin lymphoma has Reed-Sternberg cells.
Flashcards
Tap a card to flip it.
What translocation points to follicular lymphoma?
t(14;18) with BCL2 overexpression points to follicular lymphoma.
What translocation points to mantle cell lymphoma?
t(11;14) with cyclin D1 overexpression points to mantle cell lymphoma.
Quick answers
What is the fastest way to tell Follicular lymphoma from Mantle cell lymphoma?
Follicular is BCL2/t(14;18) indolent follicle disease; mantle is cyclin D1/t(11;14) aggressive mantle-zone disease.
What is the key clue for Follicular lymphoma?
Follicular lymphoma is an indolent germinal-center B-cell lymphoma with painless generalized lymphadenopathy, follicular architecture, t(14;18), and BCL2 overexpression.
What is the key clue for Mantle cell lymphoma?
Mantle cell lymphoma is an aggressive mature B-cell lymphoma with older male predominance, mantle-zone expansion, t(11;14), cyclin D1 overexpression, and possible GI polyposis.
What is the common trap with Follicular lymphoma vs Mantle cell lymphoma?
Both are mature B-cell lymphomas, so translocation and marker set prevent mixing them up.