We report here a patient with extremely indolent mantle cell lymphoma (MCL) who had progressed and required immunochemotherapy 20 years after diagnostic splenectomy. Non-nodal, indolent MCL patients may progress after such an extraordinary long indolent phase, and we recommend lifelong follow up for such cases.
Keywords: Cyclin D1; Sox11; Splenectomy; mantle cell lymphoma; somatic hypermutation analysis.