• Keitaro Ishii, Kazuharu Kamachi, Sho Okamoto, Hiroo Katsuya, Mai Fujita, Toshiaki Nagaie, Atsujiro Nishioka, Mariko Yoshimura, Hiroshi Ureshino, Yasushi Kubota, Toshihiko Ando, Tatsuro Watanabe, Mai Takeuchi, Keita Kai, Koichi Ohshima, and Shinya Kimura.
• Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan.
• Intern. Med. 2023 May 1; 62 (9): 133513401335-1340.

AbstractA 76-year-old man presented with skin plaque and splenic nodules, and diffuse large B-cell lymphoma (DLBCL) with infiltration of T-cells was suspected based on the skin lesions. The disease showed indolent clinical behavior for three months, when systemic lymphadenopathy rapidly evolved. An inguinal lymph node biopsy revealed DLBCL with abundant infiltration of T follicular helper (TFH) cells. A polymerase chain reaction-based analysis of immunoglobulin variable heavy chain showed that the skin, splenic nodules, and inguinal lymph node shared the same clone. This case indicates that the dysregulated infiltration of TFH cells in the tumor microenvironment accelerates the lymphomagenesis and progression of DLBCL.

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