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We presented an initial localization of plasmablastic lymphoma mimicking solitary plasmacytoma with widespread lymph node metastases after radiotherapy: a 68-year-old man reported lumbar pain symptoms of 3 months duration, which allowed to reveal an sacral osteolytic mass. The first diagnosis made was solitary plasmacytoma and the patient received 46 Gy by external radiotherapy. Three months later, the patient reported renal failure with deep asthenia and weight loss. The abdominal ultrasonography performed in emergency room revealed a huge retroperitoneal mass involving the both ureter with bilateral hydronephrosis. This unexpected progressive disease after radiotherapy changed the diagnosis to plasmablastic lymphoma.

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