Large B Cell Lymphoma as A Rare Cause of Gastrointestinal Bleeding and Melena in An Elderly Patient: A Case Report

Abstract

Large B-cell lymphoma is a rare form of non-Hodgkin lymphoma that can affect the gastrointestinal (GI) tract and poses diagnostic challenges owing to its non-specific symptoms. This study reports the case of a 70-year-old male with a history of cardiovascular disease who presented with melena and vague abdominal pain, initially regarded as emerging from common GI disorders. Endoscopic findings revealed large gastric ulcers with suspicious features, and biopsy confirmed the diagnosis of large B-cell lymphoma. Imaging showed metastasis, complicating the patient’s condition. Managing this case required careful balancing of antiplatelet therapy for his cardiovascular disease with the pressing need to control GI bleeding. The patient benefited from a multidisciplinary approach involving gastroenterology, cardiology, and oncology teams. This case shows the importance of early endoscopic evaluation and biopsy in elderly patients with persistent GI symptoms, as early diagnosis of rare conditions like gastric lymphoma can significantly improve treatment outcomes.