Indolent MCL is an uncommon presentation of MCL, and the majority of cases with nodal disease express SOX-11, as is true in all subtypes of MCL. Patients who present, however, with leukemic disease and splenomegaly without nodal disease are typically SOX11-negative and usually immunoglobulin heavy chain variable mutated.
Peripheral blood, bone marrow, and spleen involvement are common, and patients present with a low tumor burden a Ki-67 proliferation fraction < 10%. However, in some cases, patients may present with gastrointestinal or blood/bone marrow involvement only, which may express SOX11 and have an indolent course.
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Cite this: Ann S. LaCasce. Fast Five Quiz: Signs and Symptoms of Mantle Cell Lymphoma - Medscape - Feb 07, 2023.