A 15-year-old male presented to his primary care physician with a one month history of bilateral cervical lymphadenopathy, fever, night sweats, malaise, and weight loss. PET scans showed increased metabolic activity in multiple lymph nodes, as well as diffuse bone marrow involvement. Hematological parameters were as follows: hemoglobin 13 g/dL, hematocrit 38%, WBC 9,800/mm³, platelets 148,000/mm³. This left cervical lymph node reveals isolated residual germinal centers and a massive paracortical expansion. (H & E 2×)