Case of Gastric Diffuse Large B-Cell Lymphoma

Area of Science:

• Oncology
• Gastroenterology
• Hematology

Background:

• The gastrointestinal tract is a common site for non-Hodgkin lymphoma.
• Gastric lymphoma, particularly diffuse large B-cell lymphoma (DLBCL) and extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type, is prevalent in the United States.
• DLBCL represents an aggressive form of non-Hodgkin lymphoma requiring prompt diagnosis and treatment.

Observation:

• A patient presented with several months of sore throat, dysphagia, and hiccups, indicative of potential upper gastrointestinal pathology.
• Esophagogastroduodenoscopy revealed a significant mass at the gastroesophageal junction and cardia, causing lower esophageal stenosis.
• Histopathological analysis confirmed diffuse large B-cell lymphoma, and staging indicated advanced disease (Stage IV) with widespread lymph node involvement.

Findings:

• The case highlights a rare presentation of diffuse large B-cell gastric lymphoma.
• Diagnostic imaging confirmed advanced disease, necessitating comprehensive staging.
• The patient received R-CHOP chemotherapy, a standard regimen for aggressive B-cell lymphomas.

Implications:

• This case underscores the importance of considering gastric lymphoma in patients with atypical gastrointestinal symptoms.
• Early and accurate diagnosis through endoscopy and histopathology is crucial for effective management.
• The successful application of the R-CHOP regimen in this advanced-stage case demonstrates its efficacy in treating diffuse large B-cell gastric lymphoma.