A 34-year-old man with untreated HIV-1 infection was admitted due to obstructive jaundice and progressive, nontender swelling in the left axillary region. The HIV viral load was 412 000 copies/mL and CD4+ T-cell count was 133 cells/mm3 (11.8%). The computed tomography (CT) scan showed an expansive 3.2 cm lesion in the pancreatic head along with multiple hypodense liver lesions. Both a therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and a liver biopsy were performed, confirming stage IV diffuse large B-cell lymphoma NOS, type CCG, MYC and BCL6 double expression, with a R-IPI score of 3.

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