Incidental Finding of a Primary Polypoid Low-Grade B-Cell Gastric Lymphoma Managed with Chemotherapy

BACKGROUND This report describes the case of a 57-year-old man with an incidental finding of a primary polypoid low-grade B-cell gastric lymphoma managed with chemotherapy. The case has unique clinical features and represents an uncommon manifestation of gastric follicular lymphoma. This report seeks to raise awareness among clinicians regarding early detection and diagnosis of this condition. CASE REPORT A middle-aged man was referred for further evaluation following the incidental detection of a gastric mass during a routine health check-up. Gastroscopy revealed an irregular lesion on the gastric wall. Contrast-enhanced CT showed a well-defined polypoid mass. Endoscopic biopsy was performed, and histopathological examination showed neoplastic lymphoid follicles. Immunohistochemical staining was positive for CD20, CD10, and BCL-2, confirming a diagnosis of grade 2 follicular lymphoma. The patient underwent standard chemotherapy, consisting of rituximab, cyclophosphamide, doxorubicin (hydroxydaunorubicin), vincristine (Oncovin), and prednisone(R-CHOP), and the condition remained stable with no signs of recurrence during follow-up. CONCLUSIONS Primary follicular lymphoma of the stomach is a rare type of gastric tumor, often overlooked in early diagnosis. Standard treatment regimens, such as R-CHOP, are effective in controlling the disease. This case highlights the importance of considering lymphoma in the diagnosis of gastric subepithelial lesions, even in asymptomatic patients. It underscores the value of early endoscopic evaluation and histopathological confirmation in guiding timely and effective treatment.