Academic Editor: Giuseppe Murdaca
Background: The differential diagnosis of Burkitt lymphoma/leukemia (BL) and the double or triple hit lymphomas remains often problematic in terms of immunophenotyping in association with MYC gene analysis. In the past, BL-like B-cell malignancy with B-cell precursor phenotype (BCP-ALL) was described. Case Report: We report here an 84-year-old male with massive ascites without superficial lymphadenopathy. Abdominal paracentesis revealed chylous (non-bloody) ascites consisting of mostly abnormal BL-like blasts showing CD20-negative BCP phenotype. However, molecular study indicated no MYC/IGH, but probable involvements of MYC/IGL and BCL6/IGH translocations, which were confirmed by FISH studies. The patient was diagnosed as double hit lymphoma mimicking BCP-ALL.