A 55-year-old with diffuse large B-cell lymphoma (DLBCL) has biopsy demonstrating MYC rearrangement AND BCL-2 rearrangement by FISH. This entity is classified as:
- A High-grade B-cell lymphoma with MYC and BCL-2 rearrangements (double-hit lymphoma) ✓
- B Burkitt lymphoma
- C Follicular lymphoma grade 3B
- D Primary mediastinal large B-cell lymphoma
Correct answer: A. High-grade B-cell lymphoma with MYC and BCL-2 rearrangements (double-hit lymphoma)
Explanation
The 2022 WHO classification specifically designates B-cell lymphomas harboring concurrent MYC plus BCL-2 and/or BCL-6 rearrangements as 'High-grade B-cell lymphoma with MYC and BCL-2 rearrangements' (HGBL-MYC/BCL2), informally called double-hit or triple-hit lymphoma. These have extremely aggressive behavior and poor prognosis with standard R-CHOP, requiring intensified regimens like DA-EPOCH-R. They are distinct from Burkitt lymphoma which has isolated MYC rearrangement with specific morphology.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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