Eyad Muwaffaq Alsaqqa, Ibrahim Ajwa, DR. Roaid Khan, Dr. Aftab Ahmed
Diffuse large B-cell lymphoma (DLBCL) considered most common form of non- Hodgkin lymphoma, and it is considered as an aggressive (fast growing) that affect B- lymphocyte. The occurrence of DLBCL generally increases with age, and most patients are over the age of 60 at diagnosis. It account for about 22 percent of newly diagnosed cases of B-cell NHL in the United States. More than 18,000 people are diagnosed with DLBCL each year. [R] We report a case of 41 year old female known case of diabetes, patient reported DVT distal unprovoked 6 months ago treated by Rivaroxaban for 3 months. Take care of two children. Presented to surgery outpatient clinic with complain of left breast mass, during course of hospitalization, biopsies were taken from breast and liver showed; non-Hodgkin's lymphoma high grade diffuse large cell, germinal center type. Patient was complicated by sever lactic acidosis and hypoglycemia which found to be resistant to traditional way of treatments. The pathogenesis of malignancy induced lactic acidosis and hypoglycemia is not well understood. Prompt diagnosis and treatment of underlying lymphoma or leukemia remain the only way to achieve complete resolution of lactic acidosis and hypoglycemia for these patients.