Which among the following is not a feature of follicular lymphoma
**Core Concept**
Follicular lymphoma is a type of non-Hodgkin lymphoma characterized by the presence of malignant follicular center B cells. It is often associated with the t(14;18) chromosomal translocation, which leads to the overexpression of the BCL-2 protein, an inhibitor of apoptosis.
**Why the Correct Answer is Right**
Follicular lymphoma typically presents with a nodal mass, often with a "starry sky" appearance due to the presence of tingible body macrophages. It is also characterized by a follicular growth pattern, with a prominent mantle zone and a well-defined border. The tumor cells express B-cell markers such as CD20 and CD10, and often have a monomorphic appearance.
**Why Each Wrong Option is Incorrect**
**Option A:** While not a feature of follicular lymphoma, anaplastic large cell lymphoma can present with a similar clinical picture, but it is characterized by the presence of large anaplastic cells and a distinctive "hallmark" cell.
**Option B:** T-cell lymphomas, such as peripheral T-cell lymphoma, are not typically associated with the t(14;18) translocation and often have a different clinical presentation.
**Option C:** Mantle cell lymphoma is a distinct entity that is characterized by a different genetic abnormality (t(11;14)) and a distinct clinical presentation.
**Clinical Pearl / High-Yield Fact**
Follicular lymphoma is often associated with a favorable prognosis, but it can be challenging to distinguish from other types of lymphoma, particularly mantle cell lymphoma.
**Correct Answer:** D.