Recurrent diffuse large B-cell lymphoma presenting initially as hemophagocytic syndrome

Hemophagocytic syndrome (HPS) is an extremely rare and life-threatening abnormality, and the cases secondary to B cell lymphoma are rare. We report a case of relapsed diffuse large B-cell lymphoma initially presenting with hemophagocytic syndrome. The patient developed multiple erythematous macules and progressive thrombocytopenia during the treatment, and died two weeks after admission. The HPS presented as an initial manifestation of the relapsed diffuse B-cell lymphoma and the maculea that appeared during the treatment might be a strong predictor of unfavorable outcome.