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This case highlights an atypical presentation and consequences of diffuse large B-cell lymphoma in an elderly patient.

May 14, 2026Open Access

Diffuse Large B-Cell Lymphoma Causing Melena, Gastric Ulcer, Liver Mass, and Hypercalcemia

Key Points

This case highlights an atypical presentation and consequences of diffuse large B-cell lymphoma in an elderly patient.
Case report of a woman in her 70s with symptoms of weakness and melena.
Imaging (CT, PET) and biopsies were performed to confirm diagnosis and assess findings.
Treatment included blood transfusion and targeted therapies for hypercalcemia.
Liver mass biopsy confirmed diffuse large B-cell lymphoma.
Gastric ulcer biopsy indicated lymphoma with no active bleeding.
Patient was treated with calcitonin, prednisone, and denosumab for hypercalcemia.

Abstract

This is a case of a woman in her 70s who demonstrated an uncommon presentation and consequence of diffuse large B-cell lymphoma (DLBCL). She presented with a month of generalized weakness and 1-2 weeks of melena. She was found to be anemic and had 1,25-dihydroxyvitamin D (calcitriol)-mediated hypercalcemia. Computed tomography (CT) of the abdomen and pelvis revealed a liver mass. Esophagogastroduodenoscopy (EGD) showed a gastric ulcer, biopsied without evidence of active bleeding. Liver mass was biopsied. Positron emission tomography scan demonstrated an F-18 fluorodeoxyglucose (FDG)-avid hepatic mass with an FDG-avid lymphadenopathy above and below the diaphragm. Gastric biopsy was consistent with a lymphoma, and liver biopsy returned positive for DLBCL. She received two units of packed red blood cells. With comorbidities of heart failure and chronic kidney disease, she was judiciously given isotonic saline, calcitonin, prednisone, and denosumab for hypercalcemia.

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