High grade B cell lymphoma with 11q aberrations:report of a case and review of literature

LIU Ling; AN Hui-bo

doi:10.3969/j.issn.1007-8096.2025.04.019

Abstract：Objective: To explore the clinical pathological features, molecular genetic characteristics, diagnosis, and differential diagnosis of high-grade B-cell lymphoma with 11q abnormality (HGBCL-11q). Methods: A retrospective analysis of the clinical history of one case of HGBCL-11q was conducted. The lesion was examined by HE staining, immunohistochemistry, EBER in situ hybridization, and FISH testing. Follow-up and literature review were also performed. Results: The patient was a 13-year-old girl who was admitted due to a neck mass discovered 15 days prior. CT showed a solid mass at the right lower jaw margin, approximately 4.2 cm × 3.2 cm × 3.1 cm in size. Histologically, the lymph node architecture was destroyed, with diffuse infiltration of tumor cells, slightly nodular distribution. The tumor cells were of moderate size, with round or oval nuclei, slightly vesicular nuclei, coarse chromatin, and visible small nucleoli. There was a 'starry sky' phenomenon caused by macrophages phagocytizing apoptotic bodies. Immunophenotype: CD19, CD20, CD22, PAX-5, and BCL-2 were positive; Ki-67 (90%+), CD21, CD23, BCL-6, and C-myc (30%+) were focally positive; CD3, CD4, CD5, CD7, CD8, ALK, TDT, MUM-1, CD10, CD30, CD34, CD68, PD-1, and IgD were all negative. EBER testing was negative, and FISH testing showed a positive result for 11q23.3, negative for 11q24.3 deletion, and negative for MYC, BCL-2, and IRF4 rearrangements. After more than 3 months of follow-up, the patient was still alive with the disease. Conclusion: HGBCL-11q with 11q abnormalities is rare, commonly occurs in children and adolescents, and has a morphological appearance similar to Burkitt lymphoma/high-grade B-cell lymphoma, but is not entirely the same. Diagnosis relies on molecular biological testing.