In 2011, she had lumbar and lower limb pain and was diagnosed with diffuse large B cell lymphoma (DLBCL) at Ann Arbor stage IV by vertebral biopsy (CD20+, CD30+, CD3-, PAX5+, OCT-2+, BOB.1+, CD10-, BCL6+, MUM1+, ALK−, LMP1+) (Fig. 1A) according to 2008 World Health Organization classification.[8] Her bone marrow was free of tumor cells, while small numbers of IgG kappa and IgM lambda type M proteins were found by serum immunoelectrophoresis. Here, CD40LG is linked to neoplasm.