{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:07:06Z","timestamp":1775466426655,"version":"3.50.1"},"reference-count":16,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Primary cutaneous peripheral T\u2010cell lymphoma with T\u2010follicular helper phenotype (pcTFH\u2010PTCL) is rare, and concurrent clonal B\u2010lineage proliferations are uncommon. This lymphoma subtype presents unique diagnostic challenges due to its rarity and potential for misdiagnosis. We present a case of pcTFH\u2010PTCL in an 88\u2010year\u2010old man with pruritic nodules on the shoulders, later developing multifocal cutaneous lesions including a prominent eyebrow nodule. Biopsies showed dense dermal infiltrates of CD4 positive T cells expressing TFH markers (PD\u20101, ICOS, and BCL6). Three lesions demonstrated an identical clonal T\u2010cell receptor (TCR) gene rearrangement, confirming a clonal T\u2010cell process. Remarkably, accompanying B\u2010lineage components varied: lambda\u2010restricted plasma cells and kappa\u2010restricted B cells were identified in multiple lesions. Clonality studies revealed mostly distinct immunoglobulin heavy chain (IGH) rearrangements across separate sites, indicating independent B\u2010cell clones. Whole exome sequencing revealed a pathogenic DNMT3A p.Arg882Cys mutation in two different biopsy sites. This case represents a rare pcTFH\u2010PTCL with a persistent T\u2010cell clone coexisting with divergent clonal B\u2010 and plasma cell populations. The findings emphasize the role of TFH\u2010derived neoplasms in fostering B\u2010cell expansions and highlight the diagnostic and therapeutic complexity posed by dual\u2010lineage clonality in cutaneous lymphomas.<\/jats:p>","DOI":"10.1111\/cup.70065","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:39:31Z","timestamp":1769733571000},"page":"431-435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary Cutaneous Peripheral T\u2010Cell Lymphoma With\n                    <scp>TFH<\/scp>\n                    Phenotype With Divergent Clonal B\u2010 and Plasma\u2010Cell Populations and\n                    <scp>DNMT3A<\/scp>\n                    Mutation"],"prefix":"10.1111","volume":"53","author":[{"given":"Sahil","family":"Chaudhary","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Virginia Health  Charlottesville Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinbo","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Virginia Health  Charlottesville Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7716-6680","authenticated-orcid":false,"given":"Ifeyinwa E.","family":"Obiorah","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Virginia Health  Charlottesville Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2018-11-881268"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19987"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0b013e31821c35cb"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2016.158428"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.21791"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.3269"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1626"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2019.04.013"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001984"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01620-2"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015851"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.15377"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06947.x"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-031210-101400"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000002340"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-3775"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.70065","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cup.70065","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.70065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T08:25:47Z","timestamp":1775463947000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.70065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":16,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/cup.70065"],"URL":"https:\/\/doi.org\/10.1111\/cup.70065","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"value":"0303-6987","type":"print"},{"value":"1600-0560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,29]]},"assertion":[{"value":"2025-08-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}