Conversely, differential diagnosis should consider a rare B-ALL/LBL variant with MYC rearrangement, displaying characteristics of mature B-cell lymphomas (BCLs), such as CD20 positivity, TdT negativity, smIg expression, light chain restriction, and the IGH-BCL2 translocation (5). Here, DNTT is linked to precursor B-cell acute lymphoblastic leukemia.