Relapsed Splenic Lymphoma Mimicking Recurrent Pyelonephritis

A 68-year-old Black female with a history of hypertension, type II diabetes mellitus, nephrolithiasis complicated by recurrent pyelonephritis status post lithotripsy and nephroureteral stents, and stage IIIB diffuse large B-cell lymphoma (DLBCL) in complete remission 30 months after completing therapy with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) presented to the Emergency Department with three days of subjective fever, left flank pain, nausea, and vomiting.