Gene expression alterations in stromal cells vary across tissue sites of disease manifestation in follicular lymphoma. At sites of direct cell contact, namely lymph node and invaded bone marrow, an inflammatory TNF/LT-mediated expression signature in stromal cells provides survival support for malignant B cells. In addition, follicular lymphoma cells release extracellular vesicles that can prime stromal cells at distant sites in a cell contact–independent manner. Thus, gene expression in noninvaded bone marrow stromal cells derived from follicular lymphoma patients correlate with EV-mediated alterations. The latter is characterized by an upregulation of HSC niche factors and TGFβ signaling in stromal cells. FL, follicular lymphoma; HSC, hematopoietic stem cell. Created with BioRender.com.