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 |
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01.11.2025
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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. |
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| 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 |
| Author_xml | – sequence: 1 givenname: Takumi surname: Kitaoka fullname: Kitaoka, Takumi organization: Department of Pathology, Yonezawa City Hospital, Yonezawa, Japan – sequence: 2 givenname: Akira surname: Satou fullname: Satou, Akira organization: Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan – sequence: 3 givenname: Eiichi surname: Kitamura fullname: Kitamura, Eiichi organization: Department of Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan – sequence: 4 givenname: Keiko surname: Aizawa fullname: Aizawa, Keiko organization: Department of Internal Medicine III, Division of Hematology and Cell Therapy, Yamagata University, Faculty of Medicine, Yamagata, Japan – sequence: 5 givenname: Takeshi surname: Sudo fullname: Sudo, Takeshi organization: Department of Obstetrics and Gynecology, Yonezawa City Hospital, Yonezawa, Japan – sequence: 6 givenname: Madoka surname: Abe fullname: Abe, Madoka organization: Department of Obstetrics and Gynecology, Yonezawa City Hospital, Yonezawa, Japan – sequence: 7 givenname: Takanobu surname: Kabasawa fullname: Kabasawa, Takanobu organization: Department of Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan – sequence: 8 givenname: Kazushi surname: Suzuki fullname: Suzuki, Kazushi organization: Department of Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan – sequence: 9 givenname: Naoya surname: Uchiyama fullname: Uchiyama, Naoya organization: Department of Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan – sequence: 10 givenname: Rintaro surname: Ohe fullname: Ohe, Rintaro email: r-ooe@med.id.yamagata-u.ac.jp organization: Department of Pathology, Yamagata University Faculty of Medicine, Yamagata, Japan |
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| Title | IL-4/JAK/STAT6 pathway activation in follicle center lymphoma of the lower female genital tract: A case report |
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