Haematology: mantle cell lymphoma: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Haematology: mantle cell lymphoma

Sample item

A 65-year-old man has generalised lymphadenopathy and splenomegaly. A node biopsy shows small to medium cleaved lymphocytes in a mantle zone pattern, positive for CD5 and CD19 and negative for CD23, with nuclear SOX11 expression. Which translocation is expected?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. t(11;14) with cyclin D1 overexpression

Mantle cell lymphoma carries t(11;14), which places CCND1 under the immunoglobulin heavy chain promoter and drives cyclin D1 overexpression. It is CD5 positive like chronic lymphocytic leukaemia but CD23 negative, and it often involves the gut as lymphomatous polyposis. The course is aggressive and incurable with conventional therapy.

Option by option

  • A. t(11;14) with cyclin D1 overexpression (correct)

    t(11;14) with cyclin D1 is the defining lesion of mantle cell lymphoma.

  • B. t(8;14) with MYC overexpression

    t(8;14) with MYC characterises Burkitt lymphoma, a high-grade tumour with a starry-sky pattern.

  • C. t(14;18) with BCL2 overexpression

    t(14;18) with BCL2 is the hallmark of follicular lymphoma, which is CD10 positive and CD5 negative.

  • D. t(11;18) producing API2-MALT1

    t(11;18) is found in gastric extranodal marginal zone (MALT) lymphoma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pathology questions

Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is A, t(11;14) with cyclin D1 overexpression. Mantle cell lymphoma carries t(11;14), which places CCND1 under the immunoglobulin heavy chain promoter and drives cyclin D1 overexpression.

Why is "t(8;14) with MYC overexpression" not the answer?

t(8;14) with MYC characterises Burkitt lymphoma, a high-grade tumour with a starry-sky pattern.

Why is "t(14;18) with BCL2 overexpression" not the answer?

t(14;18) with BCL2 is the hallmark of follicular lymphoma, which is CD10 positive and CD5 negative.

Why is "t(11;18) producing API2-MALT1" not the answer?

t(11;18) is found in gastric extranodal marginal zone (MALT) lymphoma.

What concept does this question test?

It tests Haematology: mantle cell lymphoma in Pathology. It is CD5 positive like chronic lymphocytic leukaemia but CD23 negative, and it often involves the gut as lymphomatous polyposis. The course is aggressive and incurable with conventional therapy.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Haematology: mantle cell lymphoma?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.