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Diffuse large B cell lymphoma (DLBCL) is one of the most common acquired immune deficiency syndrome (AIDS)-definingmalignancies among human immunodeficiency virus -infected patients, and rectal cancer has recently emerged as a prevalentnon-AIDS-defining malignancy. We report a case of rectal squamous cell carcinoma that was metachronous with DLBCL in anHIV-infected patient who was receiving highly active antiretroviral therapy. The patient was diagnosed with DLBCL and showedcomplete remission after chemotherapy. Follow-up imaging showed increased uptake at the rectum, previously treated as lymphoma. Repeated biopsy was performed and squamous cell carcinoma of the rectum was reported. After concurrent chemoradiationtherapy, curative resection was performed.

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