Digital gangrene and Cryofibrinogenemia as the presenting signs of Unsus-pected B cell lymphoma in a hepatitis B virus (HBV) infected patient

The most frequently studied association between a hepatitis virus and Non Hodgkin lymphoma (NHL) has been with hepatitis C virus (HCV). Association with Hepatitis B virus (HBV) is less studied. In this regard mixed cryoglobulinemia (MC) is more commonly associated with HCV than HBV. Still rarer is cryofibrinogenemia in these patients. Lack of symptoms in addition its rarity delays the diagnosis of cryofibrinogenemia and thus the underlying disorders like lymphoma, etc. This case report describes the diagnosis of unsuspected B cell lymphoma in a patient who presented with absolutely no hematological signs and symptoms and underscores the importance of integrated multidisciplinary approach in the diagnosis of such rare presentations of common hematological malignancies.