Patient underwent a heart transplantation at the age of 48 for an ischemic cardiomyopathy. He was on chronic immunosuppressive medication (imuran, neoral, medrol) for seven years until he developed a right tonsillar enlargement and cervical lymphadenopathy. There was no FDG captation on PET scan. EBV-DNA titers were raised. He was treated with with 3x Mabthera followed by 4x R-CHOP. For 7 years he is in complete remission.