Upper Gastrointestinal Bleeding Secondary to Gastric Invasion by Diffuse Large B-cell Lymphoma

TL;DR

An 80-year-old man with upper gastrointestinal bleeding was found to have a rare case of stomach cancer (DLBCL) causing the bleeding, highlighting diagnostic and treatment challenges.

Contribution

This paper presents a rare case of UGIB caused by gastric DLBCL with extranodal involvement and tumor-induced neovascularization.

Findings

DLBCL can present as UGIB with gastric ulceration and extranodal spread.

Endoscopic hemostasis was complicated by tumor-induced neovascularization.

Imaging revealed multiple masses involving the liver, gallbladder, and inferior vena cava.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma subtype. We present a case of an 80-year-old male with upper gastrointestinal bleeding (UGIB), ultimately diagnosed with DLBCL involving the liver, gallbladder, inferior vena cava, and stomach, leading to a large gastric ulcer. Despite initial suspicion of alcohol-related UGIB, imaging revealed multiple masses with extranodal lymphoma involvement. Endoscopic hemostasis was attempted but was complicated by tumor-induced neovascularization. This case highlights a rare cause of UGIB and underscores the challenges in diagnosis and management of malignancy-induced bleeding.

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