A 70-year-old man presented with a recurrent right parotid mass. Five months earlier, he had presented at an outside hospital with a 4.3 × 3.2 × 2.6-cm level 2 mass in the right side of his neck. Two months after the excision, the mass recurred. Magnetic resonance imaging of the neck showed a 6 × 5-cm ill-defined mass of low signal intensity in superficial and deep parotid lobes, with infiltration of the surrounding soft tissues (Figure 1). A chest radiograph revealed multifocal opacities. Positron emission tomography–computed tomography showed diffuse hypermetabolic lymphadenopathy throughout the body and hypermetabolic activity in the right parotid gland. An excisional biopsy specimen of a level 2 lymph node on the right side demonstrated follicular hyperplasia, increased immunoblasts, germinal centers, and mantle zones, with no evidence of lymphoma.