Unexpected Hematemesis in an Adult with Rare Nodular Lymphoid Hyperplasia: A Case Report

We report a rare case of nodular lymphoid hyperplasia (NLH) in a 54-year-oldmale who presented symptoms of epigastric pain, vomiting, and an atypical episode of minorhematemesis 24 hours prior admission to the hospital. Initial investigations, including bloodtests, showed slightly low hemoglobin levels (13.4 mg/dL) and an unremarkable medicalhistory. Multiple nodular lesions, ranging in size from 2 to 5 mm were discovered during anurgent endoscopy. Some of these lesions had mucosal ulcerations on top and a 'red ringsign' around the base. No lesions on esophagus and stomach were reported. We obtainedbiopsies and confirmed the Helicobacter pylori infection through a rapid test.Histopathological examination and immunochemistry confirmed NLH, a condition that isuncommon in adults and primarily seen in pediatric populations.This unexpected cause of haematemesis has led to an atypical presentation of this very raredisease in adults. Eradication therapy was prescribed. The patient was proposed toendoscopical follow-up.

Publication History

Article published online:
27 March 2025