Double-hit lymphomas are rare tumors that are defined by a chromosomal breakpoint affecting the MYC/8q24 locus in combination with another recurrent breakpoint, mainly a t(14; 18)(q32;q21)involving BCL2. We report a case of a 38-yearold woman with a 2-month history of abdominaldistention. 18F-FDG PET showed multiple positive systemic lymph nodes, positive peritoneum, and multiple positive intra-abdominal masses. Histopathology results of the cervical lymph node were compatible with double-hit follicular lymphoma(Grade 3A)because fluorescence in situ hybridization(FISH)demonstrated both MYC rearrangement and BCL2 gene fusion. She was initially started on R-CHOP(rituximab and doxorubicin, vincristine, cyclophosphamide, and prednisolone), but after one course the regimen was changed to dose-adjusted EPOCH-R(rituximab and doxorubicin, etoposide, vincristine, cyclophosphamide, and prednisolone). However, she showed no response to this chemotherapy regimen or haploidentical stem cell transplantation. The treatment strategy included salvage chemothera- py. An autologous and/or allogeneic hematopoietic transplantation is important for non-responders to DA-EPOCH-R.

The superior therapeutic effects of antibodies targeting immune checkpoints have been reported in the treatment of various cancers including non-small cell lung cancer(NSCLC)and malignant melanoma. However, the risk of reactivity against selfantigens and the high prices of these drugs are major concerns. Previously, PD-L1 protein expression and the number of infiltrating T cells in tumor tissues were investigated by immunohistochemical staining, as biomarkers for therapeutic anti-PD- 1 antibodies. However, further research into the clinical significance of PD-L1 expression in tumor tissues is still required. A promising and comprehensive gene mutation analysis of tumor tissues and T cell repertoire analysis has recently been undertaken. Liquid biopsy, which has the benefit of being minimally invasive, has also been investigated. We are currently, investigating the utility of plasma PD-L1 protein levels as a predictive biomarker of prognosis in NSCLC. Furthermore, it is important to explore useful biomarkers and develop reliable companion diagnostics for the individualized treatment with immune checkpoint drugs.

A 72-year-old woman was referred to our hospital with complaints of macro-hematuria. The radiographic evaluation including computed tomography (CT) and magnetic resonance imaging (MRI) suggested it to be renal cell carcinoma (RCC) in her right kidney. She underwent laparoscopic nephrectomy. We diagnosed her with renal cell carcinoma associated with Xp11.2 translocation/TFE3 gene fusion, based on pathological findings and break apart of transcription factor E3 (TFE3)by fluorescence in situ hybridization. She was free of recurrence at 8 months postoperatively.