Diffuse Large B-cell Lymphoma: An Unusual Presentation

Diffuse large B-cell lymphoma (DLBCL) is the most common type of mature B-cell neoplasm accounting for 28% of this group of malignancy. African-American males ages 25 to 54 years have the highest incidence of DLBCL in comparison to other groups. Patients with DLBCL usually present with pain that is secondary to rapid growth and infiltration of this tumor in relation to the surrounding organs. These patients can also manifest with B symptoms that include fever, night sweats, and weight loss. The diagnostic test for these patients is an excisional lymph node biopsy. In this report, we discuss our experience of diagnosing a patient with DLBCL who presented with an atypical picture leading to prior months of undiagnosed symptomatic disease. We discuss our approach to this patient in order to share our own challenges and the challenging diagnostic course that the patient went through. This case was an instrumental learning experience for us, and we hope that this case will shed some insight into the broad differential when faced with a patient that comes in for vague abdominal pain