A practical algorithmic approach to mature aggressive B cell lymphoma diagnosis in the double/triple hit era: selecting cases, matching clinical benefit : A position paper from the Italian Group of Haematopathology (G.I.E.)

Virchows Arch. 2019 Oct;475(4):513-518. doi: 10.1007/s00428-019-02637-2. Epub 2019 Aug 6.


An accurate diagnosis of clinically distinct subgroups of aggressive mature B cell lymphomas is crucial for the choice of proper treatment. Presently, precise recognition of these disorders relies on the combination of morphological, immunophenotypical, and cytogenetic/molecular features. The diagnostic workup in such situations implies the application of costly and time-consuming analyses, which are not always required, since an intensified treatment option is reasonably reserved to fit patients. The Italian Group of Haematopathology proposes herein a practical algorithm for the diagnosis of aggressive mature B cell lymphomas based on a stepwise approach, aimed to select cases deserving molecular analysis, in order to optimize time and resources still assuring the optimal management for any patient.

Keywords: DLBCL; Diagnosis; Double hit; FISH; HGBL; MYC.

MeSH terms

  • Algorithms*
  • Humans
  • Immunophenotyping / methods
  • In Situ Hybridization, Fluorescence / methods
  • Lymphoma, B-Cell / diagnosis*