To our knowledge, there are only 3 case reports demonstrating BVs efficacy in patients with Hodgkin lymphoma and anaplastic lymphoma kinase (ALK) negative systemic ALCL undergoing hemodialysis for end-stage renal disease (ESRD).6, 7, 8 We present an unusual case of widespread PC ALCL that has been successfully managed with low dose BV in a patient with diabetes and ESRD requiring hemodialysis who did not respond to radiation or bexarotene. Here, ALK is linked to diabetes mellitus.