A 44-years old man presented with bone pain and B symptoms 14 years following kidney transplantation. Transaxial FDG-PET, CT and fused PET/CT images of the scrotum (left), maximum intensity projection (center) and histology of testis (right). FDG PET/CT showed a focal FDG-avide lesion in the right scrotum (white arrow) and both nodal, extranodal and bone marrow involvement in supra-and infradiaphragmatic locations. Histological analysis of the right testis revealed a large B-cell lymphoproliferation, diffusely growing between the seminiferous tubules, compatible with an EBV-negative monomorphic B-cell PTLD, type primary testicular DLBCL of germinal center B-cell origin. SUV: standardized uptake value.