t(14;22)(q32;q11) translocation involving IGH and IGL acquired at progression of splenic marginal zone lymphoma treated with rituximab, ibrutinib, and obinutuzumab.

Translocations involving immunoglobin (IG) are common in B-cell neoplasms. These IG translocations lead to the disposition of the enhancer or promoter of an IG locus, typically IGH, to a proto-oncogene, resulting in the elevated expression of the cancer gene. IG fusions play an important role in the diagnosis, prognostication, and therapy selection of B-cell lymphomas. A t(14;22)(q32;q11) translocation involving IGH and IGL is rare in lymphomas. We report herein clinicopathological characteristics, response to treatment, and outcomes of a first splenic marginal zone lymphoma case with a t(14;22)(q32;q11) translocation involving IGH and IGL treated with rituximab, ibrutinib, and obinutuzumab. Studies of additional cases are needed to elucidate the potential role of the t(14;22) translocation in lymphomagenesis and prognostication.