{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:52:17Z","timestamp":1790887937096,"version":"4.1.0"},"reference-count":25,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background and Clinical Significance: Plasmablastic lymphoma (PBL) is a rare and highly aggressive B-cell neoplasm most often associated with immunodeficiency. Transformation of chronic lymphocytic leukemia\/small lymphocytic lymphoma (CLL\/SLL) into PBL is exceptionally uncommon, particularly in immunocompetent individuals. This paper describes a rare synchronous SLL-to-PBL transformation and summarizes current knowledge on synchronous and metachronous cases reported in the literature. Case Presentation A midle-aged immunocompetent patent presented with generalized lymphadenopathy and lumbar pain. Concurrent biopsies of an axillary lymph node and a retroperitoneal mass were obtained. Diagnostic evaluation included immunohistochemistry; fluorescent in situ hybridization (FISH); PCR-based assessment of IGH, IGK, and IGL loci; and next-generation sequencing (NGS) of IGHV to assess clonal relatedness. The patient was treated with six cycles of Dara-CHOP, followed by autologous stem cell transplantation and maintenance therapy with daratumumab and ibrutinib. The axillary node showed SLL (CD20+, CD5+, CD23+), while the retroperitoneal mass demonstrated classic features of PBL (CD138+, MUM1+, MYC+, Ki-67 ~100%, CD20\u2212). FISH detected MYC rearrangement in the PBL component. PCR and NGS confirmed identical IGHV1-69 rearrangements, establishing clonal relatedness and Richter transformation. A review of published cases shows that both synchronous and metachronous CLL\/SLL-to-PBL transformations are exceedingly rare. The patient achieved partial metabolic remission after treatment and remains in sustained metabolic response 24 months after diagnosis. Conclusions: This case highlights a rare example of synchronous CLL\/SLL-to-PBL transformation in an immunocompetent patient. Integration of detailed molecular diagnostics enabled early recognition and guided a personalized treatment approach incorporating CD38-targeted therapy and BTK inhibition, resulting in an excellent long-term clinical outcome.<\/jats:p>","DOI":"10.3390\/diagnostics16050702","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T10:41:02Z","timestamp":1772188862000},"page":"702","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Plasmablastic Transformation of CLL\/SLL: The Role of Early NGS Diagnosis and Targeted Multimodal Therapy"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2054-4019","authenticated-orcid":false,"given":"Jelena","family":"Filipovi\u0107","sequence":"first","affiliation":[{"name":"Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0474-3692","authenticated-orcid":false,"given":"Sara","family":"Milo\u0161evi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Terzi\u0107","sequence":"additional","affiliation":[{"name":"Institute of Pathology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorsten","family":"Braun","sequence":"additional","affiliation":[{"name":"Department of Hematology, Universit\u00e9 Paris Nord, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), H\u00f4pital Avicenne, 93000 Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramy","family":"Rahm\u00e9","sequence":"additional","affiliation":[{"name":"Department of Hematology, Universit\u00e9 Paris Nord, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), H\u00f4pital Avicenne, 93000 Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gr\u00e9gory","family":"Lazarian","sequence":"additional","affiliation":[{"name":"Biological Hematology Department, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), H\u00f4pital Avicenne, 93000 Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thami","family":"Benboubker","sequence":"additional","affiliation":[{"name":"Biological Hematology Department, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), H\u00f4pital Avicenne, 93000 Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Soussan","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Universit\u00e9 Paris Nord, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), H\u00f4pital Avicenne, 93000 Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Anatomical and Cytological Pathology, Universit\u00e9 Paris Nord, Assistance Publique\u2013H\u00f4pitaux de Paris (AP-HP), H\u00f4pital Avicenne, 93000 Bobigny, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100824","DOI":"10.1016\/j.blre.2021.100824","article-title":"Revisiting Richter transformation in the era of novel CLL agents","volume":"49","author":"Petrackova","year":"2021","journal-title":"Blood Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e177","DOI":"10.1093\/labmed\/lmad060","article-title":"Plasmablastic transformation of chronic lymphocytic leukemia: A review of literature and report on 2 cases","volume":"54","author":"Khanna","year":"2023","journal-title":"Lab. 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