An Atypical Case of Primary Gastric Lymphoma

We report a case of a fifty-two-year old gentleman who presented with a history of early satiety after meals altered bowel habits for 1 month and fever for 2 weeks. On local examination, an intra-abdominal, non-tender, variegated swelling was found extending from left hypochondrium to the epigastric region. Contrast enhanced CT scan showed a heterogeneous mass (11 cm x 11 cm) at left upper quadrant, medial to spleen, compressing the stomach, ?Neoplastic lesion. Exploratory laparotomy found a huge irregular mass involving spleen, tail of pancreas, gerota’s fascia and greater curvature of stomach, having adhesion with diaphragm and omentum, but without any enlarged lymph nodes. En-bloc excision of mass along with spleen, tail of pancreas, and a sleeve of stomach including the greater curvature was preformed. Subsequently, histopathology and immunohistochemistry confirmed it to be a case of Diffuse Large B-Cell Lymphoma of stomach (DLBCL).The rarity of the diagnosis along with its nature of presentation, and absence of several characteristic features make this case an interesting one.