Molecular sleuthing: unmasking hidden lymphomas through plasma DNA sequencing

Diagnosing lymphomas can be challenging, particularly in atypical presentations lacking histological confirmation. We report two cases where next-generation sequencing of plasma cell-free DNA (cfDNA) enabled the early detection of diffuse large B-cell lymphoma, months before biopsy confirmation. cfDNA analysis identified key lymphoma-associated mutations, guiding diagnosis when conventional investigations were inconclusive. These findings highlight cfDNA's potential as a non-invasive diagnostic tool for occult lymphoma. While further validation is needed, cfDNA may facilitate earlier intervention in challenging cases, improving patient outcomes.