*6.3.5 Treatment and prognosis*

Histological grade correlates with prognosis with grade 1–2 follicular lymphoma cases being indolent and usually not curable by aggressive therapy; and needs to palliate patients with low-dose chemotherapy or immunotherapy (e.g., anti-CD20 antibody). Median survival is 7–9 years. Histologic transformation occurs in 30–50% of follicular lymphomas, most commonly to diffuse large B-cell lymphoma [1, 25].

## **6.4 Mantle cell lymphoma**

Mantle cell lymphoma (MCL) is an uncommon lymphoid neoplasm. It usually presents in the fifth to sixth decades of life and shows a male predominance. Virtually all mantle cell lymphomas have an (11; 14) translocation involving the IgH locus on chromosome 14 and the cyclin D1 locus on chromosome 11 that leads to overexpression of cyclin D1. The most common presentation is painless lymphadenopathy. Symptoms related to the involvement of the spleen (present in ~50% of cases) and extranodal sites are also common. In GIT present as lymphomatous polyposis of the lower gastrointestinal tract [1, 25, 52].
