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52-year-old patient with a history of chronic viral hepatitis B, presenting with a painful left laterocervical mass. Clinical examination revealed multiple painful left laterocervical adenopathies. Blood tests showed an increase in lacticodehydrogenase (391.3 IU/L) and beta-2-microglobulin (2.92mg/l). Cervico-thoraco-abdomino-pelvic CT showed four (04) latero-cervical adenomegalia. Histology of lymph node excision specimens revealed diffuse tumour proliferation. Tumor cells were small, with sparse eosinophilic cytoplasm and irregular, hyperchromatic nuclei, often clarified and nucleolated. Nuclear atypia was marked and mitotic figures rare. Immunohistochemistry showed positive staining of tumour cells for anti-CD20; anti-Bcl2 and Ki67. The diagnosis of localized lymph node marginal zone lymphoma with a large tumor mass was made.