We describe the case of a 69-year-old man with a thoracic pseudoaneurysm caused by a diffuse large B-cell lymphoma. He had a large mass inside the aortic arch. Five weeks later, an asymptomatic aneurysm protruding from the minor curvature of the distal aortic arch was observed. We suspected a mycotic pseudoaneurysm and performed total arch replacement with an omental pedicle flap graft. Intraoperative tissue cultures and histopathologic tests identified no bacteria, however. Eventually, a pathologic examination revealed that the structure initially suspected to be an intramural thrombus was a diffuse large B-cell lymphoma.
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