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A biopsy of the retroperitoneal mass confirmed a diagnosis of diffuse large B-cell lymphoma. Immunohistochemical staining further categorised this lymphoma as double expressor but not double hit.<\/jats:p>\n               <jats:p>Through multidisciplinary team involvement the patient was treated with combination steroids and chemotherapy. Given the scrotal involvement this was considered a sanctuary site for chemotherapy therefore the patient also received radiotherapy to the scrotum. He recovered well following his treatment. This case highlights how early specialist referral can identify rare variants of disease. Essential preoperative imaging with US prior to treating a presumed hydrocoele prevented inappropriate surgical excision. A multidisciplinary team approach improved the patient\u2019s outcome and is hoped to have improved his chances of recurrence-free survival.<\/jats:p>","DOI":"10.1136\/bcr-2021-247381","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T05:26:18Z","timestamp":1640928378000},"page":"e247381","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["High grade non-germinal centre-like diffuse large B-cell lymphoma double expressor presenting as a hydrocoele"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2563-5056","authenticated-orcid":false,"given":"Donnacha","family":"Hogan","sequence":"first","affiliation":[{"name":"Department of Urology, Mercy University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Hayes","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Cork University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clodagh","family":"Keohane","sequence":"additional","affiliation":[{"name":"Department of Haematology, Mercy University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7372-0100","authenticated-orcid":false,"given":"Derek Barrry","family":"Hennessey","sequence":"additional","affiliation":[{"name":"Department of Urology, Mercy University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,12,31]]},"reference":[{"key":"2025082803162927000_14.12.e247381.1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-10-530659"},{"key":"2025082803162927000_14.12.e247381.2","doi-asserted-by":"publisher","DOI":"10.3816\/CLM.2001.n.016"},{"key":"2025082803162927000_14.12.e247381.3","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-06-2508"},{"key":"2025082803162927000_14.12.e247381.4","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31646"},{"key":"2025082803162927000_14.12.e247381.5","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-10-460063"},{"key":"2025082803162927000_14.12.e247381.6","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(86)90308-6"},{"key":"2025082803162927000_14.12.e247381.7","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.cancergen.2018.08.001","article-title":"Primary extranodal diffuse large B-cell lymphomas: many sites, many entities? clinico-pathological, immunohistochemical and cytogenetic study of 106 cases","volume":"228-229","author":"Magnoli","year":"2018","journal-title":"Cancer Genet"},{"key":"2025082803162927000_14.12.e247381.8","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-05-282632"},{"key":"2025082803162927000_14.12.e247381.9","doi-asserted-by":"publisher","DOI":"10.1093\/jncimonographs\/lgu013"},{"key":"2025082803162927000_14.12.e247381.10","unstructured":"Swerdlow SH , Campo E , Harris NL . 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