INTRODUCTION: Non-Hodgkin Lymphoma (NHL) is defined as a myriad of malignant neoplasms derived from B, T, Mature B, Mature T, and NK cells. The clinical presentation of NHL varies depending of the type and the areas of involvement. Most typical can be classified into aggressive and indolent. Aggressive present acutely with a rapidly growing mass and systemic B symptoms. These include diffuse large B cell lymphoma, Burkitt lymphoma, precursor B and T lymphoblastic leukemia,/lymphoma, and Adult T cell leukemia-lymphoma. Indolent lymphomas are more insidious in nature and are slower in growth. They demonstrate slow growing hepatomegaly, splenomegaly, or cytopenias. Examples of lymphomas that typically have indolent presentations include follicular lymphoma, chronic lymphocytic leukemia/small lymphocytic lymphoma, and splenic marginal zone lymphoma. Gastrointestinal Lymphoma presents with anorexia, weight loss, nausea and vomiting. Some patients can present with GI hemorrhage and early satiety along with the mentioned symptoms listed above. CASE DESCRIPTION/METHODS: Patient is a 52 year old Hispanic woman presented outpatient for several days of diarrhea and bright red blood in the bowl. Outpatient imaging with contrast showed a soft tissue density in the left lower quadrant demonstrating inflammatory changes. Patient had no family history of CRC, other CA's or hereditary disorders. Labs demonstrated microcytic anemia and Hgb of nine. The patient received a flexible sigmoidoscopy and “25 cm from the anal verge demonstrated a large abscess appearing mass in the sigmoid colon attributable to diverticulitis.” Antibiotics were administered followed by a colonoscopy in three months. Colonoscopy demonstrated “Abscess formation 25 cm from anal verge larger than previously noted on flexible sigmoidoscopy and multiple biopsies taken and sent to pathology.” Pathology revealed “monotonous atypical infiltrate with ulceration and necrosis highly suspicious for a malignant non-Hodkin Lymphoma.” The patient was then referred to oncology and oncological surgery. DISCUSSION: This case was chosen because cases in NHL are majority male (5 to1), found on the right side of the colon (70-75% in the cecum vs 1.2-5% in the Sigmoid colon), and have B-symptoms. In our patient she had no B-symptoms and the primary presentation was in the sigmoid colon. Also, the NHL to be intramural accounts for less than 4% of all extranodal NHL. Primary site for NHL in the colon accounts for less than 1% of all acute NHL.