Recurrent chromosomal translocations in malignant lymphomas most commonly i
nvolve 18q21(bcl-2), 8q24 (c-myc) and 3q27 (bcl-6), with an incidence of 27
%, 11% and 6%, respectively, Individual cases concurrently harbouring two o
f these three rearrangements have been previously reported, This report des
cribes four patients with cytogenetic alterations affecting all three loci,
which was confirmed by molecular analysis in one case. Clinically, each pa
tient had aggressive B-cell lymphoma with disseminated disease often involv
ing the central nervous system, poor response to chemotherapy and short sur
vival, Activation of c-myc in association with deregulation of bcl-2, bcl-6
or both confers high-grade disease with a poor prognosis.