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Intravascular large B-cell lymphoma is seen in less than one per million people and can be an extremely difficult antemortem diagnosis to make due to a vast diversity of presenting symptoms. We present a case of an otherwise healthy 74-year-old woman whose predominant symptom was pitting oedema, and who likely died from multiorgan failure after &gt;14 months of extensive workup that was unable to secure a definitive diagnosis.

Severe peripheral oedema as the only presenting symptom of intravascular large B-cell lymphoma: a diagnosis too frequently made on autopsy