A pediatric high-grade B-cell lymphoma with a rare complex cytogenetic profile: A case report

Introduction: Pediatric B non-Hodgkin lymphoma (B-NHL) often presents with complex karyotypes (CK), co-occurring high-risk mutations, and treatment resistance, leading to poor outcomes. Case description: We describe a child with a CK including MYC::IGH translocation, MYC inversion, TP53 deletion, BCL6 gain, and BCL2 loss, exhibiting a high tumor burden and a partial response to standard therapy, requiring treatment intensification. Conclusion: This case emphasizes the critical role of comprehensive cytogenetic and molecular profiling to guide diagnosis, risk stratification, and therapy selection. Recognition of high-risk genetic features can inform early intensification or targeted approaches. Pediatric MYC -rearranged B-NHL with complex cytogenetics remains under-characterized but clinically aggressive, underscoring the need for multicenter studies to define its genetic spectrum, refine prognostic models, and optimize individualized treatment strategies.