2023 Volume 65 Issue 12 Pages 2401-2406
Diffuse large B-cell lymphoma (DLBCL) is a lymphoma characterized by its predilection for the stomach, and endoscopic findings often show soft protrusions with ulceration. We report a case of DLBCL that did not show such typical findings. The patient was a 76 year old male who presented with right neck swelling and malaise of four months duration. After several examinations, he was diagnosed with stage Ⅳ(Lugano classification) primary DLBCL of the right cervical lymph node. Upper gastrointestinal endoscopy showed flat white protrusions of 7 mm in size in the gastric corpus and whitish protrusions with depressed centers in the second part of duodenum. Histopathological examination of these lesions revealed proliferation of lymphoid cells in the interstitium of the lamina propria. Immunohistochemically, the tumor cells were cluster of differentiation (CD)20-positive, CD10-positive, and CD3-negative; Ki-67 labeling index was 90%. These findings led to a diagnosis of DLBCL. This case presented with atypical endoscopic findings of DLBCL such as small, flat white protrusions.
