IL-4/JAK/STAT6 pathway activation in follicle center lymphoma of the lower female genital tract: A case report

Follicle center lymphoma (FCL) of the lower female genital tract (LFGT) is a recently proposed subtype of B-cell lymphoma that resembles primary cutaneous follicle center lymphoma. Although targeted next-generation sequencing (NGS) studies have identified recurrent TNFRSF14 mutations in FCL of the L...

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Published in:Human Pathology Reports Vol. 42; p. 300805
Main Authors: Kitaoka, Takumi, Satou, Akira, Kitamura, Eiichi, Aizawa, Keiko, Sudo, Takeshi, Abe, Madoka, Kabasawa, Takanobu, Suzuki, Kazushi, Uchiyama, Naoya, Ohe, Rintaro
Format: Journal Article
Language:English
Published: Elsevier Inc 01.11.2025
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ISSN:2772-736X, 2772-736X
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Abstract Follicle center lymphoma (FCL) of the lower female genital tract (LFGT) is a recently proposed subtype of B-cell lymphoma that resembles primary cutaneous follicle center lymphoma. Although targeted next-generation sequencing (NGS) studies have identified recurrent TNFRSF14 mutations in FCL of the LFGT, its broader mutational landscape remains largely uncharacterized. We report a case of FCL of the LFGT in a woman in her 40s presenting with a cervical tumor. Histological examination revealed a predominantly diffuse proliferation of CD20+, CD79a+, BCL6+, HGAL+, CD23+, and BCL2− atypical lymphocytes, consistent with a centrocytic phenotype. Numerous T follicular helper cells were observed in the background of the lesion. Whole-exome sequencing identified 1,336 coding variants. After filtering based on tumor cell content and CADD phred score (≥20), 125 variants were retained, including a nonsense mutation in TNFRSF14 and missense mutations in IL4R and SOCS3. The TNFRSF14 mutation may contribute to the accumulation and activation of T follicular helper cells by disrupting the inhibitory HVEM–BTLA signaling pathway. In addition, IL4R and SOCS3 mutations may lead to upregulation of the IL-4/JAK/STAT6 pathway, promoting tumor cell survival and proliferation. These findings provide new insights into the molecular pathogenesis of FCL of the LFGT.
AbstractList Follicle center lymphoma (FCL) of the lower female genital tract (LFGT) is a recently proposed subtype of B-cell lymphoma that resembles primary cutaneous follicle center lymphoma. Although targeted next-generation sequencing (NGS) studies have identified recurrent TNFRSF14 mutations in FCL of the LFGT, its broader mutational landscape remains largely uncharacterized. We report a case of FCL of the LFGT in a woman in her 40s presenting with a cervical tumor. Histological examination revealed a predominantly diffuse proliferation of CD20+, CD79a+, BCL6+, HGAL+, CD23+, and BCL2− atypical lymphocytes, consistent with a centrocytic phenotype. Numerous T follicular helper cells were observed in the background of the lesion. Whole-exome sequencing identified 1,336 coding variants. After filtering based on tumor cell content and CADD phred score (≥20), 125 variants were retained, including a nonsense mutation in TNFRSF14 and missense mutations in IL4R and SOCS3. The TNFRSF14 mutation may contribute to the accumulation and activation of T follicular helper cells by disrupting the inhibitory HVEM–BTLA signaling pathway. In addition, IL4R and SOCS3 mutations may lead to upregulation of the IL-4/JAK/STAT6 pathway, promoting tumor cell survival and proliferation. These findings provide new insights into the molecular pathogenesis of FCL of the LFGT.
AbstractFollicle center lymphoma (FCL) of the lower female genital tract (LFGT) is a recently proposed subtype of B-cell lymphoma that resembles primary cutaneous follicle center lymphoma. Although targeted next-generation sequencing (NGS) studies have identified recurrent TNFRSF14 mutations in FCL of the LFGT, its broader mutational landscape remains largely uncharacterized. We report a case of FCL of the LFGT in a woman in her 40s presenting with a cervical tumor. Histological examination revealed a predominantly diffuse proliferation of CD20 +, CD79a +, BCL6 +, HGAL +, CD23 +, and BCL2 − atypical lymphocytes, consistent with a centrocytic phenotype. Numerous T follicular helper cells were observed in the background of the lesion. Whole-exome sequencing identified 1,336 coding variants. After filtering based on tumor cell content and CADD phred score (≥20), 125 variants were retained, including a nonsense mutation in TNFRSF14 and missense mutations in IL4R and SOCS3. The TNFRSF14 mutation may contribute to the accumulation and activation of T follicular helper cells by disrupting the inhibitory HVEM–BTLA signaling pathway. In addition, IL4R and SOCS3 mutations may lead to upregulation of the IL-4/JAK/STAT6 pathway, promoting tumor cell survival and proliferation. These findings provide new insights into the molecular pathogenesis of FCL of the LFGT.
ArticleNumber 300805
Author Kitaoka, Takumi
Aizawa, Keiko
Kitamura, Eiichi
Abe, Madoka
Sudo, Takeshi
Uchiyama, Naoya
Kabasawa, Takanobu
Suzuki, Kazushi
Ohe, Rintaro
Satou, Akira
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Keywords SOCS3
TNFRSF14
IL4R
Whole-exome sequencing
Follicle center lymphoma of the lower female genital tract
Language English
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Snippet Follicle center lymphoma (FCL) of the lower female genital tract (LFGT) is a recently proposed subtype of B-cell lymphoma that resembles primary cutaneous...
AbstractFollicle center lymphoma (FCL) of the lower female genital tract (LFGT) is a recently proposed subtype of B-cell lymphoma that resembles primary...
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SubjectTerms Follicle center lymphoma of the lower female genital tract
IL4R
Pathology
SOCS3
TNFRSF14
Whole-exome sequencing
Title IL-4/JAK/STAT6 pathway activation in follicle center lymphoma of the lower female genital tract: A case report
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