Targeted NGS of synchronous diffuse large B-cell lymphoma and mantle cell lymphoma

A synchronous genetically unrelated double B-cell lymphoma is currently unknown. Since DLBCL and MCL are treated differently, significant diagnostic procedures including extensive genetic analyses are of vital importance. Different mutational profiles were identified, as DLBCL harbored mutated KMT2D, CD79A, RHOA, GNAI2 and CCND3, and in contrast, MCL contained BCL1 rearrangement and ATM and BIRC3 aberrations. Consequently, the therapeutic strategy was intensified to adapt for both DLBCL and MCL. In conclusion, this case advocates for the need of low-threshold tissue examination including extensive genetic analysis if a clinical and radiological suspicion of two disease entities is present, thereby guiding optimal therapeutic strategies.