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Positron emission tomography-CT showed marked increased fluorodeoxyglucose uptake in supradiaphragmatic lymph nodes, pleuropulmonary tissue, paraspinal musculature and bone marrow. Imaging-guided and surgical incisional biopsies of the paravertebral mass were inconclusive. During hospitalisation, she developed right cervicobrachial paraesthesia. Only excisional biopsy of the mass allowed the diagnosis of high-grade B-cell lymphoma not otherwise specified, Ann Arbor stage IV-B. The patient underwent chemotherapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone), followed by R-EPOCH (rituximab, etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin hydrochloride). Follow-up at 12 months revealed complete response.<\/jats:p>","DOI":"10.1136\/bcr-2021-246791","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T05:26:23Z","timestamp":1640928383000},"page":"e246791","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Lymphoma presented as dysphagia: a diagnosis hard to swallow"],"prefix":"10.1136","volume":"14","author":[{"given":"Mafalda","family":"Jo\u00e3o","sequence":"first","affiliation":[{"name":"Gastroenterology Department, Centro Hospitalar e Universit\u00e1rio Coimbra, Coimbra, Portugal"},{"name":"Gastroenterology Department, Portuguese Oncology Institute of Coimbra, Coimbra, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rio","family":"Bento-Miranda","sequence":"additional","affiliation":[{"name":"Gastroenterology Department, Centro Hospitalar e Universit\u00e1rio Coimbra, Coimbra, 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