INTRODUCTION: Fundic Gland Polyps (FGPs) are hamartomatous cystic lesions in the gastric mucosa, and mostly occur sporadically. Bleeding from an FGP is very rare but has been reported in the setting of long-term PPI use and rare hematologic conditions. Overall, these polyps are considered quite benign. CASE DESCRIPTION/METHODS: A 71-year-old gentleman presented to the hospital in active tumor lysis and was subsequently diagnosed with Diffuse Large B Cell Lymphoma of the non-germinal center type, in a background of 3B follicular lymphoma. He was started on induction chemotherapy with the R-EPOCH regimen (without rituximab given unknown HBV status) and a day later, developed massive melena resulting in hemorrhagic shock. His chemotherapy regimen was stopped and he was resuscitated, requiring multiple transfusions. Once in stable condition, an EGD was performed which found only a benign FGP in a background of chronic atrophic gastritis as a source of the bleed (Figure 1). The pathology revealed pyloric and intestinal metaplasia, consistent with autoimmune gastritis (Figure 2), with no evidence of dysplasia or malignancy. Mesenteric angiography was subsequently performed to identify any other source of GI bleed for IR embolization, but no contrast extravasation was observed to suggest one. The patient's clinical status improved during the procedure, suggesting that the hemorrhage had ceased. DISCUSSION: The development of FGPs is a rare phenomenon. When they do form, they may form sporadically, or may be associated with hypergastrinemia seen in patients taking proton pump inhibitors, in those with Zollinger-Elison syndrome, and in those with autoimmune metaplastic atrophic gastritis (AMAU). Interestingly, our patient was found to have AMAU on pathology and there have been multiple reports of a bidirectional association between lymphocytic malignancies, like DLBCL, and autoimmune manifestations. Our patient's GI bleed was likely the result of a combination of factors, including his AMAU and his DVT prophylaxis (enoxaparin), but the most significant of these factors is the gastrointestinal side effects of his chemotherapeutic R-EPOCH (Rituximab, Etoposide, Prednisone, Oncovin, Cyclophosphamide and Doxorubicin Hydrochloride) regimen. Many of the drugs used in this regimen are known to cause mucositis, and prednisone in particular has been historically associated with GI bleeds due to mechanisms such as impaired wound healing. As seen in this case, when his chemotherapeutic regimen was stopped, his bleeding also ceased.Figure 1.: Endoscopic photograph of the fundic gland polyp.Figure 2.: The biopsy of the fundic gland polyp demonstrates cystically dilated glands arising in oxyntic-type mucosa.Figure 3.: The biopsy of the background fundic mucosa shows atrophic mucosa with loss of oxyntic glands, pseudopyloric metaplasia, and chronic inflammation in the lamina propria, compatible with autoimmune gastritis.