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Plasmablastic lymphoma (PBL) is a rare malignancy derived from activated B cells within the germinal center in the process of transformation to plasma cells. The neoplasm is an aggressive and diagnostically challenging type of lymphoma. It is most commonly associated with HIV infection, but may also occur in other immunodeficiencies, elderly patients, and immunocompetent individuals. In this paper, we discuss the clinic pathologic features of a 93- year-old male, possibly the oldest reported case, with PBL, status post-chemotherapy for Hodgkin lymphoma, initially suspected of representing reactive, possibly infectious, lymphadenopathy versus recurrent Hodgkin lymphoma.