A 50-year-old male patient was diagnosed with Large B cell lymphoblastic lymphoma. After receiving three cycles of chemotherapy with high dose cytoarabinoside + methotrexate+ endoxan presented to the medical oncology department of our hospital for further management. He was a known case of type 2 diabetes mellitus. On examination, he was conscious, oriented, afebrile, with pallor, generalized weakness, bilateral lower limb paraesthesia, hepatosplenomegaly and supraclavicular and inguinal lymphadenopathy. MRI and PET CT suggested intracranial metastasis and the patient was given first cycle of second line chemotherapy