Abstract
[TO THE EDITOR] Diffuse large B-cell lymphomas (DLBCL) are a heterogeneous group of aggressive lymphomas. Approximately 40% of all B-cell lymphomas have a recurrent reciprocal chromosomal translocation, commonly involving an oncogene and an immunoglobulin loci enhancer. Lymphomas with recurrent chromosomal breakpoints that activate multiple oncogenes, one of which is MYC, are known as "double hit" lymphomas. These chromosomal breakpoints, when present, portend a worse prognosis. Most common double-hit lymphomas involve MYC and BCL2 gene translocations. We describe a very rare case of a patient with DLBCL involving the gene loci MYC and BCL6. A 34-year-old male presents to the emergency department with bilateral lower extremity weakness and shooting pain. He was unable to ambulate without using a walker and had suffered multiple falls. He had no significant past medical or surgical history. Computed tomography scan of lumbar spine was normal so an magnetic resonance imaging (MRI) was performed that showed homogeneous hyperintense lesion extending posteriorly from L3-S1 vertebral bodies with obstruction of spinal canal.