Mantle cell lymphoma presenting with severe upper gastrointestinal bleeding: A case report

Area of Science:

• Gastroenterology
• Hematology
• Oncology

Background:

• Mantle cell lymphoma (MCL) typically involves extranodal sites, with the gastrointestinal tract affected in over 80% of cases.
• Despite frequent GI involvement, MCL is an uncommon cause of gastrointestinal bleeding, particularly severe or life-threatening hemorrhage.

Observation:

• A 60-year-old male with a history of peptic ulcer disease presented with severe upper GI bleeding and a large gastric ulcer.
• Initial diagnosis was complicated by the presence of a large gastric ulcer, leading to conservative management with blood transfusion and tranexamic acid.

Findings:

• The patient was diagnosed with primary gastric mantle cell lymphoma.
• Urgent hemostatic radiotherapy was administered, leading to patient stabilization.
• The patient was monitored in the hospital, with a definitive diagnosis of stage IV Mantle cell lymphoma confirmed.

Implications:

• Mantle cell lymphoma should be considered in the differential diagnosis of massive upper GI bleeding, especially when presenting as a bleeding gastric ulcer.
• Bleeding is an uncommon but critical presenting feature of gastrointestinal lymphoma, necessitating prompt and thorough investigation.