This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Medicine
All are true about splenic marginal zone lymphoma, EXCEPT: 
Select and explain. 
A. Autoimmune anemia / thrombocytopenia present, B. This tumor of small lymphocytes originates in the marginal zone of the spleen white pulp, C. Splenic hilar nodes are involved, D. The clinical course is virulent
D: The clinical course is virulent
Answer: D: The clinical course is virulent 
Explanation: Splenic Marginal Zone Lymphoma This tumor originates in the marginal zone of the spleen white pulp (Tumor of small lymphocytes) Splenic hilar nodes are involved The circulating tumor cells are called villous lymphocytes The cells express surface immunoglobulin and CD20 The median age of patients is fifties Patients present with incidental splenomegaly and lymphocytosis in the peripheral blood Autoimmune anemia / thrombocytopenia present The clinical course of disease is indolent Long remissions after splenectomy Ref: Harrison, E-18, e-21.