Case Report: A case of neuropsychiatric lupus with primary central nervous system diffuse large B-cell lymphoma

BackgroundThe coexistence of neuropsychiatric systemic lupus erythematosus (NPSLE) and primary diffuse large B-cell lymphoma (DLBCL) of the central nervous system (CNS) (PCNS DLBCL) is extremely rare in clinical practice. This article retrospectively analyzes the clinical manifestations, imaging exa...

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Main Authors: Yuexi Zhang, Shaoling Zheng, Yiming Li, Shuyang Chen, Xin Guo, Zhixiang Huang, Weiming Deng, Yuheng Xing, Zhengping Huang, Tianwang Li
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1636597/full
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author Yuexi Zhang
Shaoling Zheng
Yiming Li
Shuyang Chen
Xin Guo
Zhixiang Huang
Weiming Deng
Yuheng Xing
Zhengping Huang
Tianwang Li
Tianwang Li
author_facet Yuexi Zhang
Shaoling Zheng
Yiming Li
Shuyang Chen
Xin Guo
Zhixiang Huang
Weiming Deng
Yuheng Xing
Zhengping Huang
Tianwang Li
Tianwang Li
author_sort Yuexi Zhang
collection DOAJ
description BackgroundThe coexistence of neuropsychiatric systemic lupus erythematosus (NPSLE) and primary diffuse large B-cell lymphoma (DLBCL) of the central nervous system (CNS) (PCNS DLBCL) is extremely rare in clinical practice. This article retrospectively analyzes the clinical manifestations, imaging examinations, pathological diagnosis, and treatment process of a patient with NPSLE, from the appearance of intracranial abnormal signal shadows to the final diagnosis of PCNS DLBCL.Case summaryA 32-year-old Chinese female patient had previously visited our hospital due to vomiting and delirium and was diagnosed with NPSLE. In February 2021, she returned to our hospital with vomiting again. Laboratory tests revealed elevated infection markers and Epstein-Barr virus infection. Brain CT and MRI showed an abnormal intracranial lesion on the left side, which was initially considered to be a brain abscess. After one week of ineffective anti-infection treatment, the patient underwent surgery, during which the lesion was identified as a brain tumor and successfully resected. The final diagnosis was PCNS DLBCL. The patient improved after treatment and was discharged from the hospital. There has been no recurrence of NPSLE or lymphoma within three years.ConclusionWhen patients with NPSLE develop new intracranial lesions, misdiagnosis is likely to occur. Imaging and pathology are crucial, and clarifying the nature of the lesion is conducive to a good long-term prognosis.
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spelling doaj-art-6dc26385fdf545f98a1bb3cfba8b975e2025-08-21T05:27:21ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-08-011610.3389/fimmu.2025.16365971636597Case Report: A case of neuropsychiatric lupus with primary central nervous system diffuse large B-cell lymphomaYuexi Zhang0Shaoling Zheng1Yiming Li2Shuyang Chen3Xin Guo4Zhixiang Huang5Weiming Deng6Yuheng Xing7Zhengping Huang8Tianwang Li9Tianwang Li10Department of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Pathology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, ChinaDepartment of Rheumatology and Immunology, Zhaoqing Central People’s Hospital, Zhaoqing, ChinaBackgroundThe coexistence of neuropsychiatric systemic lupus erythematosus (NPSLE) and primary diffuse large B-cell lymphoma (DLBCL) of the central nervous system (CNS) (PCNS DLBCL) is extremely rare in clinical practice. This article retrospectively analyzes the clinical manifestations, imaging examinations, pathological diagnosis, and treatment process of a patient with NPSLE, from the appearance of intracranial abnormal signal shadows to the final diagnosis of PCNS DLBCL.Case summaryA 32-year-old Chinese female patient had previously visited our hospital due to vomiting and delirium and was diagnosed with NPSLE. In February 2021, she returned to our hospital with vomiting again. Laboratory tests revealed elevated infection markers and Epstein-Barr virus infection. Brain CT and MRI showed an abnormal intracranial lesion on the left side, which was initially considered to be a brain abscess. After one week of ineffective anti-infection treatment, the patient underwent surgery, during which the lesion was identified as a brain tumor and successfully resected. The final diagnosis was PCNS DLBCL. The patient improved after treatment and was discharged from the hospital. There has been no recurrence of NPSLE or lymphoma within three years.ConclusionWhen patients with NPSLE develop new intracranial lesions, misdiagnosis is likely to occur. Imaging and pathology are crucial, and clarifying the nature of the lesion is conducive to a good long-term prognosis.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1636597/fullneuropsychiatric systemic lupus erythematosus (NPSLE)primary diffuse large B-cell lymphoma of the central nervous system lymphoma (PCNSL)brain abscessmisdiagnosiscase report
spellingShingle Yuexi Zhang
Shaoling Zheng
Yiming Li
Shuyang Chen
Xin Guo
Zhixiang Huang
Weiming Deng
Yuheng Xing
Zhengping Huang
Tianwang Li
Tianwang Li
Case Report: A case of neuropsychiatric lupus with primary central nervous system diffuse large B-cell lymphoma
Frontiers in Immunology
neuropsychiatric systemic lupus erythematosus (NPSLE)
primary diffuse large B-cell lymphoma of the central nervous system lymphoma (PCNSL)
brain abscess
misdiagnosis
case report
title Case Report: A case of neuropsychiatric lupus with primary central nervous system diffuse large B-cell lymphoma
title_full Case Report: A case of neuropsychiatric lupus with primary central nervous system diffuse large B-cell lymphoma
title_fullStr Case Report: A case of neuropsychiatric lupus with primary central nervous system diffuse large B-cell lymphoma
title_full_unstemmed Case Report: A case of neuropsychiatric lupus with primary central nervous system diffuse large B-cell lymphoma
title_short Case Report: A case of neuropsychiatric lupus with primary central nervous system diffuse large B-cell lymphoma
title_sort case report a case of neuropsychiatric lupus with primary central nervous system diffuse large b cell lymphoma
topic neuropsychiatric systemic lupus erythematosus (NPSLE)
primary diffuse large B-cell lymphoma of the central nervous system lymphoma (PCNSL)
brain abscess
misdiagnosis
case report
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1636597/full
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