An aggressive "double-hit" lymphoma occurring in a 42-year-old male with both MYC and t(14;18) translocations.

We describe a 42-year-old male who was in good health until he presented with a high grade B-cell non-Hodgkin lymphoma/leukemia that had both MYC and t(14;18) translocations. This process has now been classified as "B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma," according to the 2008 World Health Organization Classification of Tumours of Haematopoitic and Lymphoid Tissues. The clinical presentation, pathologic work-up including examination of the peripheral blood, lymph node biopsy, bone marrow aspiration and biopsy are included. Treatment consisted of seven cycles of chemotherapy following the CALGB protocol 9251. Prognosis is generally reported as poor in these aggressive "double-hit" lymphomas. However, this patient's disease has now been in remission for two years.