Satyal, ShraddhaShrestha, SunilDhakal, AaratiDhakal, TejaswiDhakal, Aadarsh2026-09-302026-09-302026https://doi.org/10.3126/nmcj.v28i1.92190https://hdl.handle.net/20.500.14572/7934Abstract: Perianal ulcers are rare but clinically significant presentation in immunocompromised patients, particularly in those with hematological malignancy such as non-Hodgkin’s lymphoma (NHL). In these individuals, immunosuppression predisposes them to infections, impaired wound healing and secondary malignancies. We present a unique case of large necrotic perianal ulcer in a patient with recently diagnosed diffuse large B-cell lymphoma (DLBCL), discussing its clinical course, diagnostic and management challenges. A 55-year-old male presented with a 3 week history of perianal pain and 4 days of difficulty in micturition. Examination revealed a large necrotic ulcer with extensive tissue involvement. He had undergone incision and drainage of perianal abscess 2 months back and was recently diagnosed with non-Hodgkin’s lymphoma by biopsy 3 weeks back. Histopathological evaluation confirmed diffuse large B-cell lymphoma involving the perianal region. This case highlights the diagnostic and therapeutic challenges of managing complex perianal ulcers in immunocompromised patients.en-USPerianal ulcerDiffuse large B-cell lymphomaImmunocompromised patientArticle