Gastric DLBCL presenting as multiple gastric ulcers: a case report

Gastric diffuse large B-cell lymphoma (DLBCL) comprises most of all gastrointestinal lymphomas, accounting for approximately 55%–65% of all cases. This condition predominantly affects male patients and those older than 50 years and is usually aggressive. The clinical presentations are nonspecific and can mimic other diseases. In this report, we present a case of a 66-year-old male patient with a history of hematemesis and melena, with significant weight loss for 3 months. Esophagogastroduodenoscopy (EGD) revealed multiple stomach ulcers. A biopsy taken during EGD, which was followed by immunohistochemical staining, confirmed the diagnosis of non-Hodgkin lymphoma, specifically germinal center B-cell (GCB)–subtype DLBCL. A positron emission tomography (PET) scan was performed, revealing the involvement of the mesenteric lymph nodes and an infiltrative lesion that extended from the stomach to the pancreas. Based on the Ann Arbor staging system, the diagnosis was identified to be stage IV gastric DLBCL. Following diagnosis, we administered rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone (R-CHOP) to the patient.