B-lymphoblastic leukemia/lymphoma (B-ALL/LBL) is a precursor B-cell neoplasm that often harbors specific cytogenetic/molecular abnormalities with distinctive clinical, phenotypic, and prognostic characteristics. Subcategorization of B-ALL/LBL therefore requires extensive cytogenetic and/or molecular testing to determine the appropriate classification and therapeutic interventions for these patients. Herein, we present a case of a 17-year-old young woman diagnosed with B-LBL harboring not only an IGH::MYC rearrangement but also BCL2 and BCL6 rearrangements (so-called "triple-hit") and somatic biallelic TP53 inactivation. MYC rearrangements are relatively rare in B-ALL/LBL, and the identification of a "triple-hit" elicited an initial diagnostic dilemma. However, a multimodal approach allowed for the classification of this complex case and helped guide selection of an appropriate therapeutic regimen.

中文翻译：

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诊断三重打击 B 淋巴母细胞淋巴瘤需要进行多少次检查？（提示，很多）。

B 淋巴细胞白血病/淋巴瘤 (B-ALL/LBL) 是一种前体 B 细胞肿瘤，通常具有特定的细胞遗传学/分子异常，具有独特的临床、表型和预后特征。因此，B-ALL/LBL 的亚分类需要广泛的细胞遗传学和/或分子检测，以确定这些患者的适当分类和治疗干预措施。在此，我们介绍了一名被诊断患有 B-LBL 的 17 岁年轻女性的病例，该女性不仅携带 IGH::MYC 重排，还携带 BCL2 和 BCL6 重排（所谓的“三重打击”）和体细胞双等位基因 TP53 失活。MYC 重排在 B-ALL/LBL 中相对罕见，“三重打击”的识别引发了最初的诊断困境。然而，多模式方法可以对这种复杂病例进行分类，并有助于指导选择适当的治疗方案。