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Histopathological examination and immunohistochemistry of image-guided tissue core biopsy from the sacral mass confirmed it as high-grade diffuse large B cell lymphoma (DLBCL). With normal blood counts and bone marrow, and no lesions elsewhere on imaging, he was staged IAE and received 6\u2009cycles of R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) regimen chemotherapy followed by radiotherapy. The patient has completed a 3-year follow-up and is doing well with yearly imaging showing no evidence of active disease or recurrence.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The case shows the importance of an image-guided core biopsy and immunohistochemistry over a fine needle aspiration cytology in select cases as it can alter the treatment and outcome in patients. Because of rarity, the treatment and prognosis in primary sacral NHL is not still very clear as it is treated as per the guidelines of treatment of bone lymphoma.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12957-021-02153-1","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T15:13:19Z","timestamp":1614179599000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Primary sacral non-Hodgkin\u2019s lymphoma: report of a case and systematic review of literature"],"prefix":"10.1186","volume":"19","author":[{"given":"Satya Vijay","family":"Chigurupati","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mridula","family":"Shukla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1496-9846","authenticated-orcid":false,"given":"Manoj","family":"Pandey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,24]]},"reference":[{"issue":"1","key":"2153_CR1","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1093\/annonc\/mdl329","volume":"18","author":"KM Ramadan","year":"2007","unstructured":"Ramadan KM, Shenkier T, Sehn LH, Gascoyne RD, Connors JM. 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