{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T16:19:31Z","timestamp":1772986771056,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"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":["Pathology International"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    T follicular helper cell lymphoma (TFHL) is a systemic T\u2010cell lymphoma with a phenotype reminiscent of TFH cells and frequent\n                    <jats:italic>RHOA<\/jats:italic>\n                    p.G17V mutation. Here, we report a case of TFHL with spatially multiple and clonally independent B\u2010\/plasma cell proliferations (B\/PC\u2010Ps), which posed diagnostic difficulties. An 87\u2010year\u2010old female presented with a skin rash, and a skin biopsy from the chest was initially diagnosed as low\u2010grade B\u2010cell lymphoma with plasmacytic differentiation. Three months after rituximab monotherapy, bilateral pleural effusions developed. Cytology of the pleural effusion revealed abnormal lymphocytes and plasma cells. The abnormal T\u2010cells were positive for CD3, CD4, CD10, and PD1, while the neoplastic plasma cells showed kappa\u2010predominant light\u2010chain restriction. Additional cutaneous biopsies from the left forearm and upper arm revealed Epstein\u2010Barr virus\u2010positive and \u2010negative B\/PC\u2010Ps, respectively. Polymerase chain reaction identified\n                    <jats:italic>RHOA<\/jats:italic>\n                    p.G17V and the same monoclonal rearrangement of T\u2010cell receptor gamma gene (\n                    <jats:italic>TRG<\/jats:italic>\n                    ) in all the four specimens. In addition, three cutaneous lesions showed distinct monoclonal immunoglobulin heavy chain gene (\n                    <jats:italic>IGH<\/jats:italic>\n                    ) rearrangements. This case demonstrates phenotypic and clonal diversity of monoclonal B\/PC\u2010Ps in TFHL, which can obscure the neoplastic TFH proliferation. In such cases, careful clinicopathological correlation and the integration of immunophenotypic and genetic analyses may aid in the diagnosis.\n                  <\/jats:p>","DOI":"10.1111\/pin.70043","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T08:10:30Z","timestamp":1754986230000},"page":"532-537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatially and Clonally Multiple B\u2010\/Plasma Cell Proliferations in T Follicular Helper Cell Lymphoma: A Case Report"],"prefix":"10.1111","volume":"75","author":[{"given":"Yuka","family":"Yokota","sequence":"first","affiliation":[{"name":"Department of Pathology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9365-1093","authenticated-orcid":false,"given":"Naoki","family":"Oishi","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunari","family":"Kasai","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1106-239X","authenticated-orcid":false,"given":"Masataka","family":"Kawai","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ippei","family":"Tahara","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7162-6874","authenticated-orcid":false,"given":"Tomohiro","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuma","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Oncology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megumi","family":"Koshiish\u2010Yamada","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Oncology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5682-2132","authenticated-orcid":false,"given":"Keita","family":"Kirito","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Oncology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2268-0302","authenticated-orcid":false,"given":"Tetsuo","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Yamanashi Chuo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-01-643569"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-022-01620-2"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2022015851"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11899-023-00712-9"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.path.2023.01.011"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000002340"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3180339f18"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4898"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.14619"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375-020-0990-y"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2020.265991"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.leu.2403202"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/dc.24861"}],"container-title":["Pathology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pin.70043","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pin.70043","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pin.70043","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T10:42:14Z","timestamp":1772966534000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pin.70043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,12]]},"references-count":13,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1111\/pin.70043"],"URL":"https:\/\/doi.org\/10.1111\/pin.70043","archive":["Portico"],"relation":{},"ISSN":["1320-5463","1440-1827"],"issn-type":[{"value":"1320-5463","type":"print"},{"value":"1440-1827","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,12]]},"assertion":[{"value":"2025-05-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-04","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}