Redefining the high‐grade B cell lymphoma with double/triple rearrangements of MYC and BCL2/BCL6 genes. Learning from a case report

Socorro María Rodríguez‐Pinilla*, Rocío Nieves Salgado, Cristina Chamizo, Carlos Santonja, Peter Stewart, Nerea Carvajal, Neil McCafferty, Rebeca Manso, Daniel Morillo, Miguel Ángel Piris, David González de Castro

*Corresponding author for this work

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Abstract

We report a patient initially diagnosed with a triple hit high‐grade B cell lymphoma (HGBL‐TH), in which further morphologic, immunohistochemical, and next‐generation sequencing studies of subsequent specimens disclosed it to be a germinal center diffuse large B cell lymphoma (GC‐DLBCL) with BCL2/BCL6 gene translocations, PVT1‐deletion, and gain of MYC genes evolving from a previous follicular lymphoma. However, fluorescence in situ hybridization (FISH) studies with the break‐apart probe for MYC gene showed a fusion and two separated signals (red and green, respectively) leading to the interpretation of MYC gene translocation and a false diagnosis of a TH‐lymphoma, according to the recent WHO classification. Nevertheless, PVT1 deletion plus MYC gain/amplification has been described as a cause of the double‐hi transcription profile. These data highlight the need for new criteria to identify these highly aggressive lymphomas.
Original languageEnglish
JournaleJHaem
Early online date09 Nov 2021
DOIs
Publication statusEarly online date - 09 Nov 2021

Keywords

  • SHORT REPORT
  • SHORT REPORTS
  • B‐cell lymphomas with double or triple hits
  • fluorescence in situ hybridization
  • follicular lymphoma
  • MYC
  • PVT1

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