Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan.
Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Japan.
Intern Med. 2023 May 1;62(9):1335-1340. doi: 10.2169/internalmedicine.0521-22. Epub 2022 Sep 21.
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.
一位 76 岁男性因皮肤斑块和脾脏结节就诊，皮肤病变提示疑似 T 细胞浸润性弥漫性大 B 细胞淋巴瘤（DLBCL）。该疾病在三个月内表现出惰性的临床行为，随后全身淋巴结病迅速进展。腹股沟淋巴结活检显示富含 T 滤泡辅助（TFH）细胞浸润的 DLBCL。基于聚合酶链反应的免疫球蛋白重链可变区分析表明，皮肤、脾脏结节和腹股沟淋巴结具有相同的克隆。该病例表明肿瘤微环境中 TFH 细胞的失调浸润加速了 DLBCL 的淋巴瘤发生和进展。
