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This resemblance poses considerable diagnostic difficulty, and misdiagnosis may result in delayed treatment and unnecessary procedures, ultimately affecting patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>An 87-year-old female presented with intermittent hematochezia that acutely worsened two hours before admission. Physical examination identified a rectal mass located 5\u00a0cm from the anal verge. Pelvic imaging and colonoscopy were suggestive of hemorrhagic adenocarcinoma. Given the patient\u2019s advanced age, significant anemia, and elevated bleeding risk, a multidisciplinary team decided against preoperative biopsy. Instead, transanal minimally invasive surgery was carried out for local disease control. Final histopathological analysis of the resection specimen revealed DLBCL, germinal center B-cell-like subtype. Following surgery, the patient was referred to hematology for guideline-directed chemotherapy and remained free of recurrence during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights that rectal DLBCL can present with hematochezia as the sole symptom and may be mistaken for rectal adenocarcinoma, particularly in elderly patients. The divergence between the preoperative clinical impression and the postoperative pathological diagnosis emphasizes both the diagnostic challenge and the tailored therapeutic approach required for this rare condition. A high index of suspicion for uncommon malignancies is crucial to ensure appropriate clinical management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12672-026-04551-x","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T10:04:02Z","timestamp":1769853842000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rectal diffuse large B-cell lymphoma misdiagnosed as bleeding cancer in an elderly patient"],"prefix":"10.1007","volume":"17","author":[{"given":"Yuchun","family":"Zhong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiansen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiusi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linhui","family":"Leng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"4551_CR1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1186\/s43556-023-00141-3","volume":"4","author":"H Yang","year":"2023","unstructured":"Yang H, Xun Y, Ke C, Tateishi K, You H. 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The above content can be reflected in the patient\u2019s admission authorization form, and no further ethical approvals are required. All personal data have been processed in an anonymous form to protect patient privacy.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient provided written informed consent for the publication of her personal and clinical details, along with any identifiable images, in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Written informed consent was obtained from the patients to participate in this work and to use their case details for teaching and publication.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"376"}}