Clinicopathological analysis of large B-cell lymphoma with MYC rearrangement and 11q aberrations: a retrospective case series

Objective This study investigated the prevalence, clinicopathological features, and prognostic significance of 11q aberrations in MYC-rearranged large B-cell lymphoma (LBCL) without BCL2 and BCL6 rearrangements. Methods We retrospectively analysed 22 patients with LBCL (20 with DLBCL and 2 with HGBCL) diagnosed between 2015 and 2025. MYC rearrangement and the absence of both BCL2 and BCL6 rearrangements were confirmed by FISH. 11q status was assessed using dual-colour 11q23.3/11q24.3 probes, and correlations with clinicopathological parameters were analysed. Results 11q aberrations were detected in 9 of 20 patients with DLBCL (45%): isolated 11q24.3 deletion in nine patients (30%) and isolated 11q23.3 gain in three patients (15%). The canonical HGBCL-11q pattern (concurrent 11q23.3 gain and 11q24.3 loss) was not observed. The 11q24.3 deletion subgroup had heterogeneous clinical features and outcomes. In contrast, all 11q23.3 gain cases were older males with high-risk features and uniformly poor outcomes. Both HGBCL cases were 11q-normal. Conclusion Our findings revealed a distinct subset of MYC-rearranged LBCL with atypical 11q aberrations that differs genetically from both classical Burkitt lymphoma and canonical HGBCL-11q. Isolated 11q23.3 gain is associated with a particularly poor prognosis, whereas 11q24.3 deletion is associated with heterogeneous behaviour. This molecular subset warrants specific diagnostic and prognostic consideration.