A 62-year-old man has generalised lymphadenopathy and splenomegaly. Flow cytometry of lymph node shows CD19+, CD5+, surface Ig strong, CD10 negative, CD23 negative, and bright nuclear cyclin D1. Karyotype shows t(11;14)(q13;q32). Which statement about this lymphoma is correct?
- A It carries the worst prognosis among mature B-cell lymphomas, and transplant-eligible patients may receive cytarabine-containing induction followed by autologous stem cell transplant ✓
- B It is indolent, and observation alone is appropriate for stage IV disease
- C It responds durably to single-agent rituximab maintenance without chemotherapy
- D It is driven by BCL6 rearrangement and treated like germinal centre lymphoma
Correct answer: A. It carries the worst prognosis among mature B-cell lymphomas, and transplant-eligible patients may receive cytarabine-containing induction followed by autologous stem cell transplant
Explanation
Mantle cell lymphoma combines the CD5 positivity of CLL with CD23 negativity and strong cyclin D1 from the t(11;14) placing CCND1 under the Ig heavy chain promoter. Despite being classified as indolent histologically, it follows an aggressive clinical course and has historically the poorest outcome among A-cell lymphomas. Observation is inappropriate even at advanced stage because nearly all patients need systemic therapy, often cytarabine-based induction followed by autologous transplant in eligible cases.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.