Precise diagnosis of DHL with additional prognostic indicators and possible clinical trial

Precise diagnosis of DHL with additional prognostic indicators and possible clinical trial

Initial Workup:

• Patient diagnosed with DLBCL in left lateral thoracic back/torso-posterior to left axilla

• IHC:

  • Positive: BCL6, BCL2, PX5, cMCY

  • Negative: CD5, CD10, Cyclin D1, TdT, CD34, MUM1

• FISH:

  • Loss of 5’ MYC probe

  • Positive: IGH::BCL2

  • Negative: BCL6

Aventa testing results:

• Confirmed: IGH: BCL2, MYC Rearrangement —> DHL

• AdditionaL Loss of CDKN2A/B —> Poor prognosis; MTAP —> Clinical trial

Diagnosis & Treatment:

• High grade B-cell lymphoma with MYC and BCL2

• Escalated treatment to DA-R-EPOCH with curative intent

Patient Outcome:

• Under revised treatment plan and tolerating therapy well