Nodal T Follicular Helper Cell Lymphoma With Epstein–Barr Virus‐Positive Neoplastic T Cells Derived From Clonal Hematopoiesis
Daichi Kishi, Nobuhiro Hiramoto, Daisuke Yamashita, Hayato Maruoka, Yumi Shiroishi, Masashi Nishikubo, Yoshimitsu Shimomura, Ryusuke Yamamoto, Yuya Nagai, Yuka Torii, Hiroshi Kimura, Yasuhito Nannya, Seishi Ogawa, Tadakazu KondoABSTRACT
Introduction
Nodal T follicular helper cell lymphoma (nTFHL) with Epstein–Barr virus (EBV)‐positive neoplastic T cells is rare.
Methods
We report a woman with nTFHL and analyzed EBV‐infected cells using an immunobead‐based method and assessed somatic mutations in lymphoma and lymphoma‐uninvolved bone marrow by targeted sequencing.
Results
EBV DNA was enriched in the CD4‐positive fraction containing neoplastic T cells. Shared TET2 mutation was identified in both lymphoma and bone marrow, whereas additional TET2 and RHOA G17V mutations were restricted to the lymphoma.
Conclusion
These findings support a stepwise model of EBV‐positive nTFHL arising from TET2 ‐mutated clonal hematopoiesis with subsequent acquisition of a RHOA mutation.
Trial Registration
The authors have confirmed clinical trial registration is not needed for this submission.