Fig. 4

A 71-year-old male patient experienced out-of-field relapse after RT. He was diagnosed with DLBCL (stage III), and the initial involved sites included Waldeyer's ring, bilateral cervical, axillary, mesenteric, paraaortic, bilateral iliac, and inguinal sites (A). Patient achieved PR (residual lesions in Waldeyer's ring) after four cycles of R-CHOP, and received RT and four cycles of R-GemOx (rituximab, gemcitabine, and oxaliplatin) (B). After RT and second-line chemotherapy, patients experienced out-of-field relapse in the right cervical (C). Then, he received Bruton’s tyrosine kinase (BTK) inhibitor, but still experienced disease progression in the liver and paraaortic region (D)