Case of Gastric Diffuse Large B-Cell Lymphoma

The gastrointestinal (GI) tract is the predominant site of extra nodal lymphoma involvement. In the United States (US), gastric lymphoma is the most common extra nodal site of lymphoma. Most of these lesions are either extra nodal marginal zone B cell lymphoma of mucosa associated lymphoid tissue (MALT) type or diffuse large B cell lymphoma (DLBCL). We report a case of diffuse large B-Cell Gastric Lymphoma who initially presented with sore throat, dysphagia and hiccups for a few months. Esophagogastroduodenoscopy showed lower esophageal stenosis and a large, infiltrative, ulcerated, circumferential mass at the gastro esophageal junction and cardia. Histopathology showed diffuse large B cell lymphoma. Positron emission tomography scan showed advanced disease with presence of lymph nodes on both sides of the diaphragm. The patient was considered to have Stage IV gastric lymphoma. Subsequently, he was treated with R-CHOP regimen (rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin (vincristine), and prednisone).