In Western population, the vast majority of follicular lymphoma is of low grade and has a male to female ratio of 1:1.7.[41,42] High grade follicular lymphoma by the 2008 WHO classification is heterogeneous lymphoid neoplasm which includes large B cell lymphoma with IRF-4 rearrangement, pediatric follicular lymphoma, and follicular lymphoma, grade 3B.[43] It is different from low grade follicular lymphoma in the clinical, genetics, and even in the gender distribution. Here, IRF4 is linked to follicular lymphoma.