Abstract
Primary gastrointestinal (GI) lymphoma is a heterogeneous disease with varied clinical presentations. The stomach is the most common GI site and accounts for 70% to 75% of GI lymphomas. We present a patient with gastric diffuse large B cell lymphoma (DLBCL) who presented with significant weight loss, early satiety, and multifocal ulcerated gastric lesions. Esophagoduodenoscopy should be performed in patients presenting with warning symptoms as in our case. Diagnosis is usually made by endoscopic biopsies. Multiple treatment modalities including surgery, radiotherapy, and chemotherapy have been used. Advancements in endoscopic and pathologic technology decrease turnaround time for diagnosis and treatment initiation, thus reducing the need for surgery. Health care providers should maintain a high level of suspicion and consider gastric DLBCL as part of the differential diagnosis, especially in those with warning symptoms such as weight loss and early satiety with abnormal endoscopic findings.
Highlights
Primary gastrointestinal (GI) lymphoma is a heterogeneous disease.[1]
mucosa-associated lymphoid tissue (MALT) lymphomas arise from post–germinal center memory B cells and are related to chronic immune reactions driven by infections such as Helicobacter pylori or other autoimmune stimuli.[3,4,5,6]
We highlight a patient with gastric diffuse large B cell lymphoma (DLBCL) who presented with significant weight loss and multifocal ulcerated gastric lesions
Summary
Primary gastrointestinal (GI) lymphoma is a heterogeneous disease.[1]. Its clinical presentation varies depending on the location of the disease in the GI tract, staging, and histologic subtypes.[1]. Extranodal disease is not uncommon.[7,8] We highlight a patient with gastric DLBCL who presented with significant weight loss and multifocal ulcerated gastric lesions. The objective of this case report is to increase cognizance for the detection of gastric DLBCL. Well as minimal fluid surrounding the ascending colon without any evidence of intraabdominal lymphadenopathy He underwent an esophagogastroduodenoscopy (EGD) to investigate the cause for significant weight loss and early satiety. There was notable improvement in DLBCL-related ulcers compared to previous EGD (Figure 4A and B) He had no recurrent bleeding and subsequently underwent involved field radiation
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