Gastric lymphoma was confirmed on biopsy, which is always the differential for a homogenous lesion with aggressive features. Gastric MALToma is associated with H. pylori infection, however this case proved to be diffuse large B-cell type.

The differential is infiltrating type of adenocarcinoma, which is commonly seen in younger patients who lack E-cadherin and hence are also at risk of lobular breast carcinoma.