Diffuse large cell lymphoma is frequently localized at the time of presentation, but the aggressive natural history of the disease in most patients has suggested that extensive and intensive radiation and/or chemotherapy is necessary to control this disease. We describe a patient who has remained free of disease for 20 years after simple excision of a diffuse large cell lymphoma localized to the right cervical region. Review of the biopsy material showed characteristic histological features suggestive of an orderly growth pattern of tumor cells as well as sclerosis. The clinical course of this patient after minimal therapy emphasizes the possibility of long survival with localized large cell lymphoma and suggests that the characteristic morphologic features observed in this case should be sought in other cases, since it may imply a favourable prognosis.