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B-cell and\/or plasma cell proliferations (B\/PCP) are frequently reported in nTFHL, yet their histological spectrum remains incompletely defined. This study aims to delineate the clinical, pathological and molecular features of a retrospective series of nTFHL-associated B\/PCP, with particular emphasis on recurrent disease patterns. To this aim, we retrospectively analyzed 39 nTFHL with 45 synchronous and\/or metachronous B\/PCP, collected from five Italian referral centers for hematological disorders. Multiple B\/PCP were documented in 5\/39 (12.8%) patients. All diagnoses were established according to the 2022 WHO\/ICC criteria, using the nomenclature proposed by the 2023 SH\/EA4HP Workshop on T-cell lymphomas. Clinical and pathological data were collected, and recurrent histological patterns were categorized.\n                    <jats:italic>RHOA<\/jats:italic>\n                    <jats:sup>G17V<\/jats:sup>\n                    ,\n                    <jats:italic>TET2<\/jats:italic>\n                    ,\n                    <jats:italic>DNMT3A<\/jats:italic>\n                    , and\n                    <jats:italic>IDH2<\/jats:italic>\n                    mutations were tested in 16 cases. The cohort included 20 males and 19 females (median age: 73.3\u00a0years). B\/PCP clustered into six diagnostic categories: (i) diffuse large B-cell lymphoma (DLBCL)-like proliferations associated with nTFHL (19\/45 [42.2%]), (ii) nodular large B-cell proliferations associated with nTFHL (5\/45 [11.1%]), (iii) secondary DLBCL without co-localization of nTFHL (3\/45 [6.7%]); (iv) EBV-positive polymorphic B-cell proliferations (10\/45 [22.2%]), (v) monotypic plasma cell proliferations (5\/45 [11.1%]), and (vi) small B-cell lymphoma-like proliferations with plasma cell differentiation (3\/45 [6.7%]).\n                    <jats:italic>TET2<\/jats:italic>\n                    mutations were detected in 10\/16 (62.5%) cases with high allelic burden, whereas\n                    <jats:italic>DNMT3A<\/jats:italic>\n                    and\n                    <jats:italic>IDH2<\/jats:italic>\n                    mutations were rare. The\n                    <jats:italic>RHOA<\/jats:italic>\n                    <jats:sup>G17V<\/jats:sup>\n                    mutation was detected in 3 cases, most likely representing contamination by minor nTFHL clones. In conclusion, TFHL-associated B\/PCP are a heterogeneous group of lymphoproliferative and plasma cell disorders, displaying recurrent histological patterns and frequent clonal hematopoiesis-associated mutations. Further studies on larger cohorts of patients are warranted to elucidate their biological and clinical implications.\n                  <\/jats:p>","DOI":"10.1007\/s00428-026-04530-1","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T02:38:16Z","timestamp":1777516696000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["B-cell and plasma cell proliferations associated with T follicular helper cell lymphomas:  clinical-pathological and genetic features"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4006-7317","authenticated-orcid":false,"given":"Marco","family":"Pizzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Lorenzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"De Crescenzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio Alberto","family":"Croci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Scarmozzino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Santoro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio Eugenio","family":"Mandelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Fusi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco Angelo","family":"Cocchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piera","family":"Balzarini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Caniato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Bellan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Filippi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Scapinello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Piazza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Vianello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Pagani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"La Marra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Famengo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Bonaldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Fassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Righi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo Paolo","family":"Dei Tos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Sabattini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"issue":"11","key":"4530_CR1","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1182\/blood.2022015851","volume":"140","author":"E Campo","year":"2022","unstructured":"Campo E, Jaffe ES, Cook JR, Quintanilla-Martinez L, Swerdlow SH, Anderson KC et al (2022) The International Consensus Classification of Mature Lymphoid Neoplasms: a report from the Clinical Advisory Committee. 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Informed consent was obtained from living patients. The study was submitted and approved by the local ethical committee (CET-ACEV; study ID: 936\/A0\/24);","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Authors have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}