{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:24:28Z","timestamp":1786947868352,"version":"build-2736575974"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diffuse large B-cell lymphoma (DLBCL) involving the penis is an exceptionally rare extranodal malignancy and is frequently misdiagnosed as penile carcinoma or infectious conditions because of its nonspecific clinical presentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 58-year-old man presented with a progressively enlarging painful penile mass for 3\u202fmonths that was refractory to empirical antibiotic therapy. Ultrasound-guided core biopsy of the penile shaft mass revealed diffuse large B-cell lymphoma, centroblastic type, non\u2013germinal center B-cell subtype with MYC and BCL-2 double expression. Fluorodeoxyglucose positron emission tomography\/computed tomography (FDG PET\/CT) demonstrated intense uptake in the penis with additional gastric involvement confirmed by biopsy, consistent with Lugano stage IV disease. The patient received curative-intent systemic chemo-immunotherapy with Rituximab plus Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (R-CHOP) and subsequently achieved complete metabolic remission on follow-up FDG PET\/CT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights an unusual presentation of systemic DLBCL as a painful penile mass and underscores the pivotal role of FDG PET\/CT in detecting occult extranodal involvement, accurately staging disease, and guiding appropriate management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1882276","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:26:20Z","timestamp":1786944380000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Painful penile mass as an initial manifestation of systemic diffuse large B-cell lymphoma: a case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Min-Jung","family":"Jan","sequence":"first","affiliation":[{"name":"Department of Medical Education, Tungs\u2019 Taichung MetroHarbor Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia Hao","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Dalin Tzu Chi Hospital","place":["Dalin, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Che","family":"Ou","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Tungs\u2019 Taichung MetroHarbor Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tang-Yi","family":"Tsao","sequence":"additional","affiliation":[{"name":"Department of Pathology, Tungs\u2019 Taichung MetroHarbor Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Sheng","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Tungs\u2019 Taichung MetroHarbor Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Chuan","family":"Ou","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Tungs\u2019 Taichung MetroHarbor Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min-Che","family":"Tung","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Tungs\u2019 Taichung MetroHarbor Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Yu","family":"Hsu","sequence":"additional","affiliation":[{"name":"Division of Urology, Department of Surgery, Tungs\u2019 Taichung MetroHarbor Hospital","place":["Taichung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"631","DOI":"10.2147\/OTT.S408195","article-title":"Primary diffuse large B-cell lymphoma of the penis: a case report and literature review","volume":"16","author":"Yu","year":"2023","journal-title":"Onco Targets Ther"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e243844","DOI":"10.1136\/bcr-2021-243844","article-title":"Primary high-grade diffuse large B-cell lymphoma of the glans penis","volume":"14","author":"Fenech","year":"2021","journal-title":"BMJ Case Rep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/j.mpdhp.2024.05.008","article-title":"Penile lymphoma: a report of a rare case","volume":"30","author":"Ruane","year":"2024","journal-title":"Diagn Histopathol (Oxf)"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"3059","DOI":"10.1200\/JCO.2013.54.8800","article-title":"Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification","volume":"32","author":"Cheson","year":"2014","journal-title":"J Clin Oncol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.1016\/S0140-6736(23)02705-8","article-title":"B-cell non-Hodgkin lymphomas","volume":"403","author":"Silkenstedt","year":"2024","journal-title":"Lancet"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1056\/NEJMra2027612","article-title":"Diffuse large B-cell lymphoma","volume":"384","author":"Sehn","year":"2021","journal-title":"N Engl J Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1038\/aja.2013.21","article-title":"Primary malignant lymphoma of the glans penis: a rare case report and review of the 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