The initial diagnostic approach of VRL is largely tailored to identify B-cell lymphomas and typically comprises a combination of techniques such as cytology, flow cytometry, PCR for immunoglobulin heavy chain (IgH) rearrangement, a >50 pg/ml value of Interleukin (IL)-10 or a ratio of IL-10/IL-6 > 112, and the identification of MYD88 mutations involving codon L265 (present in 60–80% of cases)13. This evidence concerns the gene IL10 and B-cell non-Hodgkin lymphoma.