Diffuse Large B-cell Lymphoma Involving an Abundant Infiltration of T Follicular Helper Cells

• Published in: Internal Medicine Vol. 62; no. 9; pp. 1335 - 1340
• Main Authors: Ishii, Keitaro, Kamachi, Kazuharu, Okamoto, Sho, Katsuya, Hiroo, Fujita, Mai, Nagaie, Toshiaki, Nishioka, Atsujiro, Yoshimura, Mariko, Ureshino, Hiroshi, Kubota, Yasushi, Ando, Toshihiko, Watanabe, Tatsuro, Takeuchi, Mai, Kai, Keita, Ohshima, Koichi, Kimura, Shinya
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.05.2023; Japan Science and Technology Agency
• Subjects: Aged; B-cell lymphoma; Biopsy; Case Report; DLBCL; Helper cells; Humans; Infiltration; Internal medicine; Lymph nodes; Lymph Nodes - pathology; Lymphadenopathy; Lymphocytes B; Lymphocytes T; Lymphoma, Follicular - pathology; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - pathology; Male; Metastases; Nodules; Skin diseases; Skin lesions; Spleen; T follicular helper cells; T Follicular Helper Cells - pathology; THRLBCL; Tumor Microenvironment; T follicular helper cells; DLBCL; THRLBCL
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.0521-22

A 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.