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This patient had been treated for diffuse large B-cell lymphoma involving the cervical lymph nodes. He subsequently presented with left-sided hydronephrosis and was found to have an irregular thickening of the left ureter. A biopsy showed recurrent lymphoma. He underwent nephroureterectomy followed by chemotherapy and radiation. There is transmural involvement of the ureter and extension into the periureteral adipose tissue.

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