All of the following NHL involve the white pulp of spleen Except
The white pulp of the spleen is where lymphoid tissue is found, so NHLs that originate from B-cells or T-cells might target this area. Let me recall the common NHL subtypes. Follicular lymphoma, for example, is a B-cell NHL that often affects the spleen's white pulp. So if an option includes follicular lymphoma, it's not the answer.
Then there's mantle cell lymphoma, another B-cell type that can involve the spleen. Diffuse large B-cell lymphoma (DLBCL) is also known to infiltrate the spleen's white pulp. But what about T-cell NHLs? Maybe they don't target the white pulp as much. Let me think—peripheral T-cell lymphoma (PTCL) is a T-cell NHL. Since the white pulp is mainly B-cell areas, PTCL might not involve it. So if one of the options is PTCL, that could be the correct answer.
Wait, but I should check if there are exceptions. Maybe some T-cell lymphomas can involve the spleen. However, the question is about the exception, so the one that doesn't typically involve the white pulp. So if the options include a T-cell NHL, that's the answer. The other options (B-cell NHLs) would be incorrect because they do involve the white pulp.
Now, I need to structure the explanation according to the user's guidelines. The core concept is about NHL subtypes and their spleen involvement. The correct answer would be a T-cell lymphoma like PTCL. The wrong options would be B-cell types like follicular, mantle cell, or DLBCL. The clinical pearl is that B-cell NHLs typically affect the white pulp, while T-cell types don't. Let me make sure the options are correctly labeled and each incorrect option is explained why they are wrong.
**Core Concept**
Non-Hodgkin's lymphomas (NHL) involving the spleen's white pulp are typically B-cell origin, as the white pulp is rich in B-lymphocytes. T-cell NHLs, such as peripheral T-cell lymphoma (PTCL), rarely infiltrate the white pulp due to their distinct anatomical predilection for red pulp or extranodal sites.
**Why the Correct Answer is Right**
Peripheral T-cell lymphoma (PTCL) is a T-cell NHL that primarily affects the red pulp (macrophage-rich areas) or extranodal sites like skin and gastrointestinal tract. The spleen's white pulp is B-cell dominated, making it less susceptible to T-cell lymphomas. PTCL lacks the B-cell lineage markers (e.g., CD19, CD20) and thus does not infiltrate the white pulp.
**Why Each Wrong Option is Incorrect**
**Option A:** Follicular lymphoma (B-cell NHL) commonly involves the white pulp, forming follicle-like structures.
**Option B:** Mantle cell lymphoma (B-cell NHL) infiltrates the white pulp, often with a "mantle zone" pattern.
**Option C:** Diffuse large B-cell lymphoma (DL