Publication Date

1-1-2024

Journal

Pediatric and Developmental Pathology

DOI

10.1177/10935266241230600

PMID

38468555

PMCID

PMC11340240

PubMedCentral® Posted Date

3-11-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Burkitt Lymphoma, Lymphoma, Large B-Cell, Diffuse, Proto-Oncogene Proteins c-bcl-2, Adolescent, Male, Translocation, Genetic, Child, Female, Diagnosis, Differential, Biomarkers, Tumor, Chromosomes, Human, Pair 14, Neoplasm Recurrence, Local, Chromosomes, Human, Pair 8, BCL2, Burkitt, DLBCL, aggressive b-cell non-Hodgkin lymphoma, B-NHL, ICC, WHO-HAEM5, pediatric

Abstract

We present 2 diagnostically challenging cases of pediatric/adolescent relapsed/refractory aggressive mature B-cell non-Hodgkin lymphoma (B-NHL) within the spectrum of Burkitt lymphoma and diffuse large B-cell lymphoma and illustrate the different therapeutic regimens that are employed for pediatric and adult cancer centers. Both cases displayed varying-sized lymphoma cells with occasional single prominent nucleoli and heterogeneous BCL2 expression. Cytogenetics revealed complex karyotypes with t(8:14)(q24.2;q32) and IGH::MYC rearrangement by FISH. Next generation sequencing revealed deleterious TP53 and MYC mutations. We concluded that both could be diagnosed as “DLBCL-NOS with MYC rearrangement” using the current pathologic classifications, 2022 International Consensus Classification (ICC) and World Health Organization Classifications of Haematolymphoid Tumors (WHO-HAEM5). This report illustrates diagnostic challenges and treatment dilemmas that may be encountered, particularly for adolescent and young adults (AYA).

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