Aggressive genetic “double-hit” B-cell lymphoma following renal transplantation: case report
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- Bailey, N.G., Betz, B.L., Roulston, D. et al. J Hematopathol (2013) 6: 39. doi:10.1007/s12308-012-0152-x
B-cell lymphomas with two oncogenic chromosomal translocations (“double-hit” lymphomas [DHL]) often exhibit morphologic and immunophenotypic features intermediate between conventional diffuse large B-cell lymphoma and Burkitt's lymphoma (BL). DHL are highly aggressive neoplasms that respond poorly to current treatment strategies. A case of DHL that arose in a patient with a history of renal transplantation, diagnosed in a skin biopsy, is described. The lymphoma had morphologic features reminiscent of BL; however, in addition to the IGH@-MYC fusion, BCL6 was translocated to chromosome 13 in the presence of a complex karyotype. This case exhibits very unusual features: lymphomas with both MYC and BCL6 translocations are rare, and posttransplant DHL have virtually never been described. The importance of identifying patients with DHL is emphasized, as these patients require alternative therapeutic approaches.