SPEN and lymphoma: These mutations are thought to contribute to lymphoma invasiveness and poor prognosis.[13] Molecular classifications of DLBCL have identified the BN2 subtype as having relatively favorable prognoses due to activation of the BCL-6 and NOTCH signaling pathways.[14] However, the truncating/inactivating mutation of SPEN, observed in this patient, may indicate high-risk molecular features.