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Although reactive germinal centers (GCs) are common in B\u2010cell CLH, cases with mantle zone hyperplasia (MZH), a rare phenomenon reported in reactive lymphadenopathy, have never been documented. We report a case of CLH with MZH showing weak BCL\u20106 expression, complicating its distinction from cutaneous B\u2010cell lymphoma (CBCL). A 57\u2010year\u2010old man presented with erythematous nodules on the face. Biopsy showed diffuse B\u2010cell infiltrates with lymph follicles. BCL\u20106 was weakly positive in lymphocytes outside the GCs, raising concerns about CBCLs, such as primary cutaneous follicle center lymphoma (PCFCL). However, the infiltrate outside the GCs expressed IgD and TCL1 and was confirmed to be an expanded mantle zone. The absence of cyclin\u2010D1 expression ruled out mantle cell lymphoma. Although Southern blotting showed weak clonal bands, polymerase chain reaction\u2010based clonality analysis and ultrasensitive RNA in\u00a0situ hybridization for kappa and lambda chains did not detect clonal B\u2010cell proliferation, leading to the diagnosis of CLH. Herein, we report BCL\u20106\u2010positive cutaneous MZH as a novel subtype of CLH, highlighting the limitations of BCL\u20106 positivity in extrafollicular B\u2010cells as an indicator for CBCLs, as it can be observed outside the GCs.<\/jats:p>","DOI":"10.1111\/cup.14820","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T07:59:16Z","timestamp":1746431956000},"page":"482-486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>BCL<\/scp>\u20106\u2010Positive Cutaneous Mantle Zone Hyperplasia: A Novel Subtype of B\u2010Cell Cutaneous Lymphoid Hyperplasia"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-4612-9789","authenticated-orcid":false,"given":"Atsushi","family":"Naito","sequence":"first","affiliation":[{"name":"Department of Dermatology Kyoto University Graduate School of Medicine  Kyoto 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